^^"^ 


A. 


'^:^:2>^^o 


Columbia  ^mberj6:tt|> 

mtbtCftpotMeto^arh 


l&tUnntt  Ktbrarg 


George  W.TobiaSjM.D. 

W.  133rd  Street, 

New  York; 


Hebraic  Circumcision. 


(From  an  old  sixteenth  century  Italian  print  in  the  author's  collection, 
representing  the  scene  of  the  Holy  Circumcision.) 


No.   11   IN  THE  PHYSICIANS'. AND  STUDENTS'    READY 
REFERENCE  SERIES. 


HISTORY 

OF 

CIRCUMCISION 


FROM    THE 


EARLIEST  TIMES  TO  THE  PRESENT. 


Moral  and  Physical  Reasons  for  its  Performance, 

WITH  A 

HISTORY  OF  EUNUCHISM,  HERMAPHRODISM,  ETC.,  AND 

OF  THE  DIFFERENT  OPERATIONS  PRACTICED 

UPON  THE  PREPUCE. 


P.  C.  REMONDINO,  M.D. 

(JEFFERSON), 

Member  of  the  American  Medical  Association,  of  the  American  Public  Health  Association, 

of  the   San  Diego   County  Medical  Society,   of  the  State  Board  of  Health  of 

California,  and  of  the  Board  of  Health  of  the  City  of  San  Diego; 

Vice-President  of  California  State  Medical  Society  and  of 

Southern  California  Medical  Society,  etc. 


Philadelphia  and  London  : 

THE  F.  A.  DAVIS  CO.,  PUBLISHERS, 
1891. 


C-\&S-'^ 


Entered  according  to  Act  of  Congress,  in  the  year  1891,  by 

F.  A.  DAVIS, 

In  the  Office  of  the  Librarian  of  Congress,  at  Washington,  D.  C,  TJ.  S.  A. 


Philadelphia,  Pa.,  XJ.  S.  A.: 

The  Medical  Bulletin  Printing  House, 

1231  Filbert  Street. 


PREFACE. 


In  ancient  Egypt  the  performance  of  circumcision 
was  at  one  time  limited  to  the  priesthood,  "who,  in  ad- 
dition to  the  cleanliness  that  this  operation  imparted 
to  that  class,  added  the  shaving  of  the  whole  bodj"  as  a 
means  of  farther  purification.  The  nobilit}',  royalty, 
and  the  higher  warrior  class  seem  to  have  adopted  cir- 
cumcision as  well,  either  as  a  hygienic  precaution  or  as 
an  aristocratic  prerogative  and  insignia.  Among  the 
Greeks  we  find  a  like  practice,  and  we  are  told  that  in 
the  times  of  Pythagoras  the  Greek  philosophers  were 
also  circumcised,  although  we  find  no  mention  that  the 
operation  went  beyond  the  intellectual  class.  In  the 
United  States,  France,  and  in  England,  there  is  a  class 
which  also  observe  circumcision  as  a  hygienic  precau- 
tion, where,  from  my  personal  observation,  I  have  found 
that  circumcision  is  thoroughly  practiced  in  every  male 
member  of  many  of  the  families  of  the  class, — this 
being  the  phj^sician  class.  In  general  conversation  with 
phj^sicians  on  this  subject,  it  has  really  been  surprising 
to  see  the  large  number  who  have  had  themselves  cir- 
cumcised, either  through  the  advice  of  some  college  pro- 
fessor while  attending  lectures  or  as  a  result  of  their 

(iii) 


iv  Preface. 

own  subsequent  convictions  when  engaged  in  actual  prac- 
tice and  daily  coming  in  contact  both  with  the  benefits 
that  are  to  be  derived  in  the  way  of  a  better  physical, 
mental,  and  moral  health,  as  well  as  with  the  many  dan- 
gers and  disadvantages  that  follow  the  uncircumcised, — 
the  latter  being  probably  the  most  frequent  incentive 
and  determinator, — as  in  many  of  these  latter  examples 
the  operation  of  circumcision,  with  its  pains,  annoy- 
ances, and  possible  and  probable  dangers,  sink  into  the 
most  trifling  insignificance  in  comparison  to  some  of  the 
results  that  are  daily  observed  as  the  tribute  that  is 
paid  b}'^  the  unlucky  and  unhappy  wearer  of  a  prepuce 
for  the  privilege  of  possessing  such  an  appendage. 

There  is  one  thing  that  must  be  admitted  concerning 
circumcision  :  this  being  that,  among  medical  men  or 
men  of  ordinary  intelligence  who  have  had  the  opera- 
tion performed,  instead  of  being  dissatisfied,  they  have 
extended  the  advantages  they  have  themselves  received, 
by  having  those  in  their  charge  likewise  operated  upon. 
The  practice  is  now  much  more  prevalent  than  is  sup- 
posed, as  there  are  many  Christian  families  where  males 
are  regularly  circumcised  soon  after  birth,  who  simply 
do  so  as  a  hj^gienic  measure. 

Tor  the  benefit  of  these,  who  may  congratulate 
themselves  upon  the  dangers  and  annoyances  that  they 


Preface.  v 

» 
and  their  families  have  escaped,  and  for  the  benefit  of 

those  who  would  run  into  these  dangers  but  for  timely 

warning,  this  book  has  been  especiallj^  written.     To  my 

professional  brothers  the  book  will  prove  a  source  of 

instruction  and  recreation,  for,  while  it  contains  a  lot 

of  pathology  regarding  the  moral  and  physical  reasons 

why  circumcision   should  be  performed,  which   might 

be  as  undigestible  as  a  mess  of  Boston  brown  bread 

and  beans  on  a  French  stomach,  I  have  endeavored  to 

make  that  part  of  the  book   readable  and  interesting. 

The  operative  chapter  will  be  particularly  useful   and 

interesting  to  phj'sicians,  as  I  have  there  given  a  careful 

and  impartial  review  of  all  the  operative  procedures, — 

from  the  most  simple  to  the  most  elaborate, — besides 

paying  more  than  particular  attention  to  the  subject  of 

after-dressings.      The  part   that  relates   to  the  natural 

history  of  man  will  interest  all  manner  of  people.     I 

regret  that  the  tabular  statistics  are  not  to  be  had,  but 

in  this  regard  we  must  use  our  best  judgment  from  the 

material  we  have  on  hand  ;  at  any  rate,  I  have  tried  to 

furnish  a  suflScieney  of  facts,  so  that,  unless  the  reader 

is  too  overexacting,  he  will  not  find  much  diflSculty  in 

arriving  at  a  conclusion  on  the  subject. 

P.  C.  Remondino,  M.D. 

San  Diego,  California,  1891. 


CONTENTS. 


PAGE 

Preface, iii 


Introduction,  . 


CHAPTER  I. 
Antiquity  of  Circumcision, 21 

CHAPTER  II. 

Theories  as  to  the  Origin  of  Circumcision,       .      28 

CHAPTER  III. 
Spread  of  Circumcision, 34 

CHAPTER    IV. 
Circumcision  Among  Savage  Tribes.  .        .        .42 

CHAPTER  V. 

Infibulation,    Muzzling,     and    other     Curious 

Practices, 46 

CHAPTER    VI. 
Attempts  to  Abolish  Circumcision,     ...       63 

(vii) 


viii  Contents. 

PAGE 

CHAPTER  VII. 
Miracles  and  the  Holy  Prepuce,        ...       70 

CHAPTER  VIII. 

History     of     Emasculation,     Castration,     and 

Eunuchism, 82 

CHAPTER    IX. 

Philosophical      Considerations      Relating     to 

Eunuchism  and  Medicine,       ....     105 

CHAPTER   X. 
Hermaphrodism  and  Hypospadias,        .        .        .117 

CHAPTER    XI. 
Religio  Medici, 134 

CHAPTER  XII. 
Hebraic  Circumcision,  .        .        .        .        .        .143 

CHAPTER  XIII. 

Mezizah,  the  Fourth  or  Objectionable  Act  of 

Suction,   .         ,         . 150 

CHAPTER  XIV. 
What  are  the  Benefits  of  Circumcision?.        .     161 

CHAPTER  XV. 

Predisposition  to  and  Exemption  and  Immunity 

FROM  Disease,  .         .        .        .        .         .        .183 


Contents.  ix 

PAGE 

CHAPTER  XVI. 
The  Prepuce,  Syphilis,  and  Phthisis,  .         .     187 

CHAPTER  XVII. 
Some  Reasons  for  Being  CiRcrMcisED,         .        .     200 

CHAPTER   XVIII. 

The   Prepuce   as  an   Outlaw,  and  its   Effects 

ON  THE  Glans, 206 

CHAPTER   XIX. 

Is     THE     Prepuce    a    Natural     Physiological 

Appendage? ,217 

CHAPTER  XX. 

The  Prepuce,  Phimosis,  and  Cancer,  .        .        .     226 

CHAPTER  XXL 
The  Prepuce  and  Gangrene  op  the  Penis,         .     236 

CHAPTER  XXII. 
The  Prepuce,  Calculi,  and  other  Annoyances,  .     248 

CHAPTER  XXIII. 
Reflex  Neuroses  and  the  Prepuce,    .        .        .     254 

CHAPTER  XXIV. 
Dysuria.  Enuresis,  and  Retention  of  Urine,     .     2T5 


X  .  Contents. 

PAGE 

CHAPTER  XXV. 

General    Systemic    Diseases    Induced    by    the 

Prepuce, 284 

CHAPTER  XXVI. 
Surgical  Operations  Performed  on  the  Prepuce,    302 

JSToTES  to  Text, 323 

Works  and  Authorities  Quoted,         .        .        .    336 
Index, 389 


INTRODUCTION. 


This  book  is  the  amplification  of  a  paper,  tlie  subject 
of  whicli  was,  "  A  Plea  for  Circumcision  ;  or,  tlie  Dangers 
tliat  Arise  from  tlie  Prepuce,"  which  was  read  at  the 
meeting  of  the  Southern  California  Medical  Society,  at 
Pasadena,  in  December,  1889.  The  material  gathered 
for  that  paper  was  more  than  could  be  used  in  the 
ordinary  limits  of  a  society  paper;  it  was  gathered  and 
ready  for  use,  and  this  suggested  its  arrangement  into 
book  form.  The  subject  of  the  paper  was  itself  sug- 
gested by  a  long  and  personal  observation  of  the  changes 
made  in  man  by  circumcision.  From  the  individual 
observation  of  cases,  it  was  but  natural  to  wish  to  en- 
large the  scope  of  our  observation  and  comparison  ; 
tliis  naturally  led  to  a  stud}'  of  the  phj'sical  character- 
istics of  tiie  only  race  that  could  practically  be  used  for 
the  purpose.  This  race  is  tlie  Jewish  race.  On  carefully 
studying  into  the  subject,  I  plainly  saw  that  much  of 
tlieir  longevity  could  consistently  be  ascribed  to  their 
more  practical  humanitarianism,  in  caring  for  their  poor, 
their  sick,  as  well  as  in  their  generous  provision  for 
their  unfortunate  aged  people.  The  social  fabric  of  the 
Jewish  fixmily  is  also  more  calculated  to  promote  lono- 
life,  as,  strangely  as  it  may  seem,  family  veneration  and 
family  love  and  attachment  are  far  more  strono-  and 
practical  among  this  people  than  among  Christians, 
this  sentiment  not  being  even  as  strong  in  the  Christian 
races  as  it  is  in  tlie  Chinese  or  Japanese.  It  certainly 
forms  as  much  of  a  part  of  the  teachings  of  Christianity 
as  it  does  of  Judaism,  Buddhism,  or  Confucianism,  only 

'         '  (1) 


2  Introduction. 

Christians,  as  a  mass,  have  practically  forgotten  it.  The 
occupation  followed  by  the  Jews  also  in  a  certain  degree 
favors  longevity,  and  the  influence  on  heredity  induced 
by  all  these  combined  conditions  goes  for  something. 
But  it  is  not  alone  in  the  matter  of  simple  longevitj' — 
although  that  implies  considerable — that  the  Jewish 
race  is  found  to  be  better  situated.  Actual  observations 
show  them  to  be  exempt  from  many  diseases  which  affect 
other  races  ;  so  that  it  is  not  onlj-  that  they  recover  more 
promptly,  but  that  they  are  not,  as  a  class,  subjected  to 
the  loss  of  time  b}^  illness,  or  to  the  consequent  suffer- 
ings due  to  illness  or  disease,  in  anything  like  or  like 
ratio  with  other  people. 

There  is  also  a  less  tendency  to  criminality,  debaucli- 
er}- ,  and  intemperance  in  the  race  ;  this,  again,  can  in  ft, 
measure  be  ascribed  to  their  familj-  influence,  which 
even  in  our  daj^  has  not  lost  that  patriarchal  influence 
which  tinges  the  home  or  familj^  life  ia  the  Old  Testa- 
ment. Crimes  against  the  person  or  property  committed 
by  Jews  are  rare.  They  likewise  do  not  figure  in  either 
police  courts  or  penitentiary  records ;  they  are  not  in- 
mates of  our  poor-houses,  but,  what  is  also  singular,  they 
are  never  accused  of  man}^  sillj'  crimes,  such  as  indecent 
exposures,  assaults  on  young  girls  ;  nor  do  they  figure  in 
any  such  exposures  as  the  one  recently  made  bj^  the 
Pall  Mall  Gazette. 

After  allowing  all  that,-  which  we  can,  in  its  fullest 
limit,  to  religion,  familj^,  or  social  habit,  there  is  still  a 
wide  margin  to  be  accounted  for.  This  has  naturallj^ 
let  the  inquir_y,  followed  in  the  course  of  this  book,  into 
a  careful  review  of  the  Jewish  people  ;  into  tlieir  religion 
and  its  character,  its  relation  to  other  creeds,  and  to  the 
world's  history;  into  their  many  wanderings,  and  into 
the  dispersion,  and  we  have  even  been  obliged  to  follow 


Introduction.  3 

them  into  the  midst  of  the  people  among  wliom  they 
have  become  nationed,  to  try,  if  possible,  to  find  the 
cause  of  this  racial  difference  in  health,  resistance  to 
disease,  decay,  and  death.  It  has  been  necessary,  in  fol- 
lowing out  the  research,  to  give  a  condensed  resume  of 
the  religious,  political,  and  social  condition  of  the  Jewish 
commonwealth,  which,  although  in  a  state  of  dispersion, 
still  exists.  I  need  offer  no  apology  for  the  extended 
iiotice  this  has  received  in  the  coui'se  of  the  book.  We 
read  with  increasing  interest  either  Hallam  or  May, 
Buckle  or  Guizot,  through  the  spasmodic,  halting,  retro- 
grading, advancing,  erratic,  aimless,  and  accidental 
piiases  that  England  has  plowed  through,  from  the 
days  of  goutless,  simple,  and  chaste,  but  barbarian 
England  of  the  Saxons,  to  the  present  civilized,  en- 
lightened, gouty, "Darkest  England"  of  General  Booth; 
and,  after  all  is  said  and  done,  we  are  no  wiser  in  anj'^ 
l)ractical  resulting  good.  We  simply  know  that  the 
English  people,  so  to  speak,  have,  as  it  were,  gone  tlirough 
the  figures  of  some  social  aspects,  as  if  dancing  the 
'•  Lancers,"  with  its  forward  and  back  movements,  gallop, 
etc.,  and  have  finall}^  sat  down,  better  dressed  and  better 
housed,  but  in  an  acquired  state  of  moral  and  plij'sical 
degeiioration.  The  Briton  of  Queen  Yictoria  is  not  the 
Briton  of  Queen  Boadicea,  either  morallv  or  physically. 
On  the  other  hand,  the  system  of  sociological  tables 
adopted  by  Herbert  Spencer  would  have  but  little  to 
record  for  some  six  thousand  j-ears — either  in  religion, 
morals,  or  physique — as  making  any  changes  in  the 
histor}^  of  that  simple  people  which,  in  the  mountainous 
regions  of  Ur,  in  distant  Armenia,  started  on  its  pil- 
grimage of  life  and  racial  existence;  in  one  branch  of 
the  family — that  of  Ishmael — the  changes  to  be  recorded 
are  so  invisible  that   its  descendants  may  really  be  said 


4  Introduction. 

to  live  to-day  as  they  lived  then.  So  that  I  do  not  feel 
that  1  need  to  apologize  for  the  space  I  have  given  to 
this  snbject  in  the  course  of  the  book.  The  causes  that 
make  tliese  racial  distinctions  should  be  of  interest  alike 
to  the  moralist,  theologist,  sociologist,  and  to  the  phy- 
sician. 

Ecclesiastical  writers  and  moralists,  as  well  as  writers 
of  fiction  or  dramatizers,  can  write  on  an^^thing  they 
please,  and  it  is  eagerly  taken  up  and  read  by  the  people 
generally,  either  of  high  or  low  degree,  alike  ;  and  some- 
how these  people  seem  never  to  require  an  apology  on 
the  part  of  the  author,  for  having  attempted  rapes,  se- 
ductions, or  even  unavoidable  fornication  committed 
through  the  leaves  of  the  stor^',  or  having  it  imaginably 
take  place  between  acts  on  the  stage.  But  if  the  ph}-- 
sician  writes  a  book  touching  an^'thing  connected  with 
the  generative  functions,  and  with  the  best  intent  and 
for  the  good  of  humanity,  he  is  expected  to  make  some 
prefatory  apology.  He  is  supposed  to  address  a  public 
wlio  all  of  a  sudden  have  become  intensely'  moral  and 
extremely  sensitive  in  their  modestj''.  Wh}^  things 
are  thus  I  cannot  explain.  They  are  so,  nevertheless. 
From  the  time  that  the  celebrated  Astruc  wrote  his 
treatise  on  female  diseases,  near  the  end  of  the  seven- 
teenth centur}'^, — who  felt  compelled  by  the  extreme 
modesty  of  the  people  in  this  particular — but  who,  out- 
side of  medicine,  were  about  as  virtuous  as  the  average 
Tabby  or  Tom  cats  in  the  midnight  hour — to  write  the 
chapter  touching  on  nymphomania  in  Latin,  so  as  not  to 
shock  the  morbidly  sensitive  modest}"  of  the  French 
nobility,  who  then  enjoyed  Le  Droit  de  cuissage, — down 
through  to  Bienville,  who  wrote  the  first  extended  work 
on  nymphomania,  and  Tissot,  who  first  broached  the 
subject  and  the  danger  of  Onanism,  all  have  felt  that 


Introduction.  5 

they  must  stop  on  the  thresliokl  and  "  apologize."  Tissot, 
however,  seemed  to  possess  a  robust  and  a  plain  Hip- 
pocratic  mind,  and  as  he  apologized  he  could  not  help 
hut  see  the  ridiculousness  of  so  doing,  as  in  the  preface 
to  his  work  we  find  the  following:  "Shall  we  remain 
silent  on  so  important  a  subject  ?  B}^  no  means.  The 
sacred  authors,  the  Fathers  of  the  Church,  who  i)resent 
their  thoughts  in  living  words,  and  ecclesiastical  authors 
have  not  felt  that  silence  was  best.  I  have  followed 
their  example,  and  shall  exclaim,  with  St.  Augustine, 
'  If  what  I  have  written  scandalizes  any  prudish  persons, 
let  them  rather  accuse  the  turpitude  of  their  own 
thoughts  than  the  words  I  have  been  obliged  to  use.'" 

For  my  part,  I  think  that  people  who  can  go  to  the 
theatre  and  enjoy  "  As  in  a  Lookiug-Glass,"  and  witness 
some  of  the  satyrical  or  bill3'-goat  traits  of  humanity  so 
graphically  exhibited  in  "La  Tosca,"  with  evident 
satisfaction  ;  or  attend  the  more  robust  plays  of  "  Yir- 
ginius "  or  of  "  Galba,  the  Gladiator,"  with  all  its 
suggestions  of  the  Caesarian  section,  and  the  lust  and 
the  fornications  of  an  intensely  animal  Roman  empress, 
without  the  destruction  of  their  moral  equilibrium  or 
tending  to  induce  in  them  a  disposition  to  commit  a 
rape  on  the  first  met, — I  think  such  people  can  be  safely 
intrusted  to  read  this  book. 

And  as  to  the  reading  public,  there  are  hut  few 
general  readers  who  could  honestl}'^  plead  an  ignorance  of 
the  "Decameron,"  Balzac,  La  Fontaine,  "  Heptameron," 
Grebillon  fils^  or  of  matter-of-fact  Monsieur  le  Docteur 
Maitre  Rabelais, — works  which,  more  or  less,  carry  a 
moral  instruction  in  every  tale,  which,  like  the  tales  of 
the  "  Malice  of  Women,"  in  the  unexpurged  edition  of 
the  literal  translation  of  the  "Arabian  Nights,"  contains 
much  more  of  practical  moral  lessons,  even  if  in  the 


6  Introduction. 

flowery  and  warm,  spiced  language  of  the  Orient,  than 
an}'^  supposed  nastiness,  on  account  of  which  the}^  are 
chissed  among  the  prohibited.  To  these,  and  the  readers 
of  Amelie  Rives's  books,  or  other  intensel}"  realistic 
literature,  I  need  not  imitate  the  warning  of  Ansonius, 
who  warned  his  readers  on  the  threshold  of  a  part  of 
his  book  to  "  stop  and  consider  well  their  strength 
before  proceeding  with  its  lecture."  Metaphorical!}^ 
speaking,  the  general  theatre-going,  or  modern  literature- 
reading  public,  can  be  considered  pretty  callous  and 
morally'  bullet  proof.  I  shall  therefore  make  no  apology. 
Some  fault  maj',  perhaps,  be  found  with  some  of  the 
occasional  st^le  of  the  book,  or  with  some  of  the  sub- 
jects used  to  illustrate  a  principle.  To  the  extremely 
wise,,  good,  and  scientific,  these  illustrations  were  un- 
necessary ;  this  need  hardly  be  mentioned ;  and  the 
passages  which  to  some  may  prove  objectionable  were 
not  intended  for  them,  either  with  the  expectation  of 
delighting  them  or  with  the  purpose  of  shocking  them. 
These  passages,  they  can  easily  avoid.  This  book, 
however,  was  written  that  it  might  be  read  :  not  only  i-ead 
by  the  Solon,  Socrates,  Plato,  or  Seueca  of  the  laity  or 
the  profession,  but  even  by  the  billy -goated  dispositioned, 
vulgar  plebeian,  who  could  no  more  be  made  to  read  cold, 
scientific,  ungarnished  facts  than  you  can,  make  an 
unwilling  horse  drink  at  the  watering-trough.  Human 
weakness  and  perversity  is  silly,  but  it  is  sillier  to  ignore 
thiit  it  exists.  So,  for  the  sake  of  boring  and  driving  a 
few  solid  facts  into  the  otherwise  undigesting  and  un- 
thinking, as  well  as  primarilj^  obdurate  understanding 
of  the  untutored  plebeian,  I  ask  the  indulgence  of  the 
intelligent  and  broad-minded  as  well  as  the  easiU"  in- 
ducted reader.  Cleopatra  was  smuggled  into  Caesar's 
presence  in  a  roll  of  tapestry ;  the  Greeks  introduced 


Introduction.  7 

their  men  into  Tro}^  by  means  of  a  wooden  horse;  and 
the  discoverer  of  the  broad  Pacific  Ocean  made  his 
escape  from  his  importunate  creditors  disguised  as  a 
cask  of  merchandise.  So,  when  we  wish  to  accomplish 
an  object,  we  must  adopt  appropriate  means,  even  if 
they  may  appareiitl,y  seem  to  have  an  entirely  diametric- 
ally opposite  object.  The  Athenian,  Themistocles,  when 
wishing  to  make  the  battle  of  Salamis  decisive,  was  in- 
spired with  the  idea  of  sending  word  to  the  Persian 
monarch  that  the  Greeks  were  tr3ing  to  escape,  advisino- 
him  to  block  the  passage ;  this  saved  Greece. 

There  is  a  weird  and  ghostly  but  interesting  tale 
connected  with  the  Moslem  conquest  of  Spain,  of  how 
Roderick,  the  last  of  the  Gothic  kings,  when  in  trouble 
and  worry,  repaired  to  an  old  castle,  in  the  secret  re- 
cesses of  which  was  a  magic  table  whereon  would  pass 
in  grim  procession  the  diflerent  events  of  tlie  future  of 
Spain  ;  as  he  gazed  on  the  enchanted  table  he  there  saw 
his  own  ruin  and  his  country's  and  nation's  subjugation. 
Anatomy  is  generally  called  a  dry  stud}^  but,  like  the 
enchanted  brazen  table  in  the  ancient  Gothic  castle,  it 
tells  a  no  less  weird  or  interesting  tale  of  the  past.  Its 
revelations  lighten  up  a  long  vista,  through  the  thou- 
sands of  years  through  which  the  human  species  has 
evolved  from  its  earliest  appearance  on  earth,  gradually 
working  up  through  the  different  evolutionary  processes 
to  wliat  is  to-day  supposed  to  be  the  acme  of  perfection 
as  seen  in  the  Indo-European  and  Semitic  races  of  man. 
Anatomy  points  to  the  rudiment — still  lingering,  now 
and  then  still  appearing  in  some  one  man  and  without  a 
trace  in  the  next — of  that  climbing  muscle  which  shows 
man  in  the  past  either  nervously  escaping  up  the  trunk 
of  a  tree  in  his  flight  from  man^-  of  the  carnivorous  ani- 
mals with  whom  he  was  contemporary,  or,  as  the  shades 


8  Introduction. 

of  iiiglit  were  beginning  to  gather  aronnd  him,  we  again 
see  him  by  the  aid  of  these  nmscles  leisure!}'  climbing 
up  to  some  hospitable  fork  in  the  tree,  where  the  robust 
habits  of  the  age  allowed  him  to  find  a  comfoi'table 
resting-place  ;  protected  from  the  dew  of  the  night  by 
the  overhanging  branches  and  frijm  the  prowling  hyena 
by  the  height  of  the  tree,  he  passed  the  niglit  in  security. 
The  now  useless  ear-muscles,  as  well  as  the  equally  use- 
less series  of  muscles  about  the  nose,  also  tell  us  of  a 
movable,  flapping  ear  capable  of  being  turned  in  any 
direction  to  catch  tlie  sound  of  approaching  danger,  as 
well  as  of  a  movable  and  dilated  nostril  that  scented  dan- 
ger from  afar, — the  olfactory  sense  at  one  time  having  a 
ditferent  function  and  more  essential  to  life  than  that  of 
merely  noting  the  differential  aroma  emitted  by  segars 
or  cups  of  Mocha  or  Java,  and  the  ear  being  then  used 
for  some  more  useful  pur[)ose  tlian  having  its  tympanum 
toi'tured  b}^  Wagnerian  discordant  sounds.  Our  ances- 
tors might  not  have  been  a  very  handsome  set,  nor, 
judging  from  the  Neanderthal  skull,  could  they  have 
had  a  ver^^  winning  physiognomy,  but  they  were  a  ver}' 
hardy  and  self-reliant  set  of  men.  Nature — always  care- 
ful that  nothing  should  interfere  with  the  procreative 
functions — had  provided  him  with  a  sheath  or  prepuce, 
wherein  he  carried  his  procreative  organ  safely  out  of 
harm's  way,  in  wild  steeple-chases  through  thorny  briars 
and  bramble-brakes,  or,  when  hardl}^  pushed,  and  not 
able  to  climb  quickly  a  tree  of  his  own  choice,  he  was 
by  circumstances  forced  up  the  sides  of  some  rough- 
barked  or  tliorny  tree.  This  leather}^  pouch  also  pro- 
tected him  from  the  many  leeches,  small  aquatic  lizards, 
or  other  animals  that  infested  the  marshes  or  rivers 
through  which  he  had  at  times  to  wade  or  swim;  oi' 
served  as  a  protection  from  the  bites  of  ants  or  other 


Introduction.  9 

vermin  when,  tired,  he  rested  on  bis  haunches  on  some 
mossy  bank  or  sand-hill. 

Man  has  now  no  use  for  any  of  these  necessaries 
of  a  long-past  age, — an  age  so  remote  that  the  specu- 
lations of  Ernest  Renau  regarding  the  differences 
between  the  Semitic  race  of  Shem  and  the  idolatrous 
descendants  of  Ham,  away  off  in  the  far  mountains 
and  A-alleys  of  Asia  Ij'ing  between  the  Mediterra- 
nean Sea  and  the  Euphrates,  seem  more  as  if  he 
were  discussing  an  event  of  3'esterda3^  than  something 
which  is  considered  contemporary  with  our  earlier  his- 
tor3% — and  we  find  them  disappearing,  disuse  graduallj^ 
producing  an  obliteration  of  this  tissue  in  some  cases, 
and  the  modifying  influence  of  evolution  producing  it 
in  others  ;  the  climbing  muscle,  probably  the  oldest 
remnant  and  legac}'  that  has  descended  from  our 
long-haired  and  muscular  ancestry,  is  the  best  ex- 
ample of  disappearance  caused  by  disuse,  while  the 
efiectual  disappearance  of  the  prepuce  in  man}'  cases 
shows  that  in  that  regard  there  exists  a  marked  dif- 
ference in  the  evolutionary  marcli  among  different 
individuals. 

There  is»a  strange  and  unaccountable  condition  of 
things,  however,  connected  with  the  prepuce  that  does 
not  exist  with  the  other  vestiges  of  our  arboreal  or 
sylvan  existence.  Firstl}^  the  other  conditions  have 
nothing  that  interferes  with  their  disappearance ;  whereas 
the  prepuce,  by  its  mechanical  construction  and  the 
expanding  portions  which  it  incloses,  tends  at  times 
rather  to  its  exaggerated  development  than  to  its  dis- 
appearance. Again,  whereas  the  other  vestiges  have  no 
injury  that  they  inflict  by  their  presence,  or  danger  that 
they  cause  their  possessors  to  run,  the  prepuce  is  from 
time  of  birth  a  source  of  annoyance,  danger,  suffering, 


10  Introducti'on. 

find  deatli.  Then,  again,  the  other  conditions  are  not 
more  developed  at  hirtli ;  whereas  the  prepuce  seerns,  in 
our  pre-natal  life,  to  have  an  unusual  and  unseen-for-use 
existence,  being  in  bulk  out  of  all  proportion  to  the 
organ  it  is  intended  to  cover.  Speculation  as  to  its 
existence  is  as  unprolific  of  results  as  any  we  maj'^ 
indulge  in  regarding  the  nature,  object,  or  uses  of  that 
other  evolutionary  appendage,  the  appendix  vermiformis, 
the  recollection  of  whose  existence  always  ad^s  an 
extra  flavor  to  tomatoes,  figs,  or  an^^  other  small-seeded 
fruits. 

We  may  well  exclaim,  as  we  behold  this  appendage 
to  man, — now  of  no  use  in  health  and  of  the  most 
doubtful  assistance  to  the  verj^  organ  it  was  intended 
to  protect,  when  that  organ,  through  its  iniquitous 
tastes,  has  got  itself  into  trouble,  and,  Job-lilce,  is  l.ying 
repentant  and  sick  in  its  manj^  wrappings  of  lint,  with 
perhaps  its  companions  in  crime  imprisoned  in  a  sus- 
pensory bandage, — what  is  this  prepuce  ?  Whence,  why, 
where,  and  whither  ?  At  times.  Nature,  as  if  impatient 
of  the  slow  march  of  gradual  evolution,  and  exasperated 
at  this  persistent  and  useless  as  well  as  dangerous  relic 
of  a  far-distant  prehistoric  age,  takes  things  in  her  own 
hands  and  induces  a  sloughing  to  take  place,  which 
rids  it  of  its  annoj^ance.  In  the  far-off  land  of  Ur, 
among  the  mountainous  regions  of  Kurdistan,  something- 
over  six  thousand  3'ears  ago,  the  fathers  of  the  Hebrew 
race,  inspired  by  a  wisdom  that  could  be  nothing  less 
than  of  divine  origin,  forestalled  the  process  of  evolu- 
tion by  establishing  the  rite  of  circumcision.  Whether 
this  has  been  beneficial  or  injurious  to  the  race  will  be, 
in  a  measure,  the  object  of  the  discussion  in  this  book. 

One  object  of  this  book  is  to  furnish  my  professional 
brotliers  with  some  embodied  facts  that  they  ma}^  use  in 


Introduction:  11 

convincing  the  lait}"  in  man}'  cases  where  they  themselves 
are  convinced  that  circumcision  is  absolutel}'  neces- 
sary-;  but, -having  nothing  in  their  text-hooks  to  back 
up  their  opinion  with,  their  explanations  are  too  apt  to 
pass  for  their  mere  unfounded  personal  view  of  the 
matter.  If  tiie  patient,  or  the  parents  of  the  patient, 
ask  the  physician  for  his  authority,  he  is  at  a  loss,  as 
there  is  nothing  that  deals  with  the  subject  in  Viwy  ex- 
tended manner;  so  that  this  book  has  been  written  in  as 
plain  English  as  the  subject-matter  could  possibly  allow, 
so  that  non-professionals  could  easily  read  and  under- 
stand it.  I  have  often  felt  the  need  of  such  a  work ; 
people  can  understand  emergency  or  accident  surgerj^, 
militarj^  surgery,  or  reparative  surgery,  but  such  a  thing 
as  surger}' to  remed}'  a  seemingly  medical  disease, -or 
what  might  be  called  the  preventive  practice  of  surgery, 
is  something  they  cannot  understand.  First,  and  not 
the  least,  among  the  incentives  to  skepticism  on  this 
subject  is  the  unwelcome  fact  of  a  surgical  operation, 
which,  no  matter  how  trivial  it  may  seem  to  the  surgeon, 
is  a  matter  of  considerable  magnitude  to  the  patient,  his 
parents,  or  friends  ;  there  are  risks,  pain,  worry,  annoy- 
ances, and  expenses  to  be  undergone, — considerations 
which,  either  singly  or  unitedly,  often  lead  one  to 
reason  against  the  operation,  even  when  otherwise  con- 
vinced of  its  need  or  utilit3\ 

The  hardest  to  convince  are  those,  however,  who 
insist  on  having  a  four-and-a-half- foot-gauge  fact  driven 
through  their  two-foot-gated  understanding,  without 
it  ever  occurring  to  them  that  the  gate,  and  not  the 
fact,  is  the  fault}'  article.  Some  of  these  gentry  are 
very  unconvincible.  They  at  times  remind  one  of  that 
description  given  by  Carlyle  in  regard  to  one  of  the 
Georges^  who    found   himself,  when    Prince  of  Wales, 


12  Intr'oduction. 

leading  an  army  in  Flanders,  and  actually  engaged  in  a 
battle.  His  Ro^al  Highness  was  on  foot,  and  was  seen 
standing  facing  the  enem}-,  with  outstretched  legs,  like 
a  Colossus  of  Rhodes,  impassive  and  stolid, — the  very 
impersonification  of  Dutch  courage  and  aggressiveness. 
There  he  stood,  unconscious  whether  he  was  at  the  head 
of  an  army  or  single  attendant ;  he  might  be  overridden 
and  annihilated,  overturned  and  expunged,  but  there  he 
would  most  assuredly  stand  and  fall,  if  need  be;  over- 
whelming sqnadrons,  by  their  impetus  and  weight,  might 
ride  him  down  and  crush  him  ;  but  one  thing  was  most 
certain,  this  certain  fact  being  that  he  never  could  be 
made  to  retreat  or  advance,  as  no  impression  from  front 
or  rear  could  convince  him  of  the  necessit}^  of  either. 

Then,  there  is  our  statistical  friend,  who  cannot  dis- 
criminate between  the  exception  and  the  rule  b}-  any 
common-sense  deductions.  He  must  have  all  the 
authentic,  carefully-compiled  statistics  before  he  can 
allow  himself  to  form  an^^  opinion.  As  long  as  there 
is  the  smallest  fraction  of  a  decimal  unaccounted  for  in 
a  mathematical  wa}^,  this  individual  is  inconvincible. 
These  men  pride  themselves  upon  being  methodically^ 
exact;  they  express  their  willingness  to  be  convinced  if 
30U  can  present  acceptable  proofs;  but,  trying  to  pre- 
sent simple  rational  proofs  to  these  individuals  is  con- 
siderably like  presenting  a  meal  of  boiled  pork  and 
cabbage  to  a  confirmed  and  h^^pochondriacal  dyspeptic, 
— it  only  increases  their  mental  dyspepsia. 

Had  Columbus  waited  to  discover  America,  or  had 
Galileo  waited  to  proclaim  the  motion  of  the  earth,  nntil 
authorized  to  a  serious  consideration  of  the  matter  by 
properl}' -tabled  statistics,  they  would  have  w^aited  a 
long,  long  time;  and,  it  may  be  added,  the  inconve- 
nienceg  that  attend  the  proving  of  a  negative  will   so 


Introduction.  13 

interfere  with  the  proper  arrangement  of  statistical 
matter  which  relates  to  the  prepuce  and  circumcision 
that,  before  such  tables  could  be  satisfactorily'  and  con- 
vincingly constructed,  time  and  the  evolutionary^  proc- 
esses that  follow  it  will  bid  fair  to  completely  remove 
this  debatable  appendage  from  man.  It  maj'  be  at  a 
A'ery  far-distant  period  that  tliis  evolutionary  preputial 
extinction  will  take  place, — probably  contemporary  with 
the  existence  of  Bulvver's  '•  Coming  Race," — but  not  at 
a  too  remote  period  for  the  proper  and  satisfactory 
tabulation  of  the  statistics. 

The  ideas  of  the  etiology  and  pathological  processes 
through  which  we  journe3', — from  a  condition  of  health 
and  good  feeling  to  one  of  disease,  miserable  feeling,  and 
death, — as  described  in,  or  rather  as  the}'  control  the 
sentiment  and  polic}'  of,  this  work,  are  such  as  have  been 
followed  by  Hutchinson,  Fothergill,  Beale,  Black,  Al- 
butt,  and  Richardson  ;  so  that  if  I  have  totally  ignored 
the  old  conventional  sj^stems,  with  their  hide-bound 
classification  of  diseases  to  control  the  etiolog}^,  I  have 
not  done  so  without  some  reliable  autliority.  In  studying 
the  etiology  of  diseases  we  have,  as  a  rule,  been  content 
to  accept  the  disease  when  fully  formed  and  properly 
labeled,  being  apparently  satisfied  with  beginning  our 
investigation  not  at  the  -  initial  point  of  departure 
from  health,  but  at  some  distant  point  from  this, — at 
the  point  where  this  departure  has-  elaborated  itself,  on 
favorable  ground,  into  a  tangible  general  or  local  dis- 
ease. As  truthfully  observed  by  T.  Clifford  Albutt : 
"  The  philosophic  inquirer  is  not  satisfied  to  know  that 
a  person  is  suflfering,  for  example,  from  a  cancer.  He 
desires  to  know  why  he  is  so  suffering, — that  is,  what  are 
the  processes  which  necessaril}^  precede  or  follow  it. 
He  wishes  to  include  this  phenomena,  now  isolated,  in 


14  Introduction. 

a  series  of  which  it  must  necessarily  be  but  a  member, 
to  trace  the  period  of  which  it  must  be  but  a  pliase.  He 
believes  that  diseased  processes  have  tlieir  evolution 
and  the  laws  of  it,  as  have  other  natural  processes,  and 
he  believes  that  these  are  fixed  and  knowable,"  To  do 
this,  the  physician  must  travel  beyond  the  beaten  path  of 
etiology  as  found  in  our  text-books.  He  must  follow 
Hutchinson  in  the  train  of  reasoning  that  elucidates  the 
pre-cancerous  stage  of  cancer,  or  tread  in  the  path  fol- 
lowed by  Sir  Lionel  Beale,  in  finding  that  the  cause  of 
disease  depends  on  a  blood  change  and  the  develop- 
mental defect,  or  the  tendency  or  inherent  weakness 
of  the  affected  part  or  organ ;  to  fully  appreciate  the 
inherent  etiological  factors  that  reside  in  man,  and 
which  constitute  the  tendenc}^  to  disease  or  premature 
decay  and  death,  we  must  also  be  able  to  follow  Can- 
statt.  Day,  Rostan,  Charcot,  Rush,  Cheyne,  Humphr}^ 
or  Reveille-Parise  into  tlie  study  of  the  different  con- 
ditions which,  though  normal,  are  nevertheless  factors 
of  a  slow  or  a  long  life.  We  must  also  be  able  to  ap- 
preciate fully  the  value  of  that  interdependence  of  each 
part  of  our  organism,  which  often,  owing  to  a  want  of 
equilibrium  of  strength  and  resistance  in  some  part 
when  compared  to  the  rest,  causes  the  whole  to  give 
Avaj',  just  as  a  fiaw  in  a  levee  will  cause  the  whole  of  the 
solidl3--constructed  mass  to  give  wa}^  or  a  demoralized 
regiment  may  entail  the  utter  route  of  an  army.  As 
described  by  George  Murray  Humphry,  in  his  instruc- 
tive work  on  "  Old  Age,"  at  page  11  : — 

"  The  first  requisite  for  longevity  must  clearly  be  an 
inherent  or  inborn  quality  of  endurance,  of  steady,  per- 
sistent nutritive  force,  which  includes  reparative  force 
and  resistance  to  disturbing  agencies,  and  a  good  propor- 
tion or  balance  between  the  several  organs.     Each  organ 


Introduction.  15 

must  be  sound  in  itself,  and  its  strength  must  have  a 
due  relation  to  the  strength  of  the  other  organs.  If  the 
heart  and  the  digestive  system  be  disproportionately 
strong,  the}'  will  overload  and  oppress  the  otlier  organs, 
one  of  which  will  soon  give  way;  and,  as  the  strength 
of  the  human  bod}",  like  that  of  a  chain,  is  to  be  meas- 
ured by  its  weaker  link,  one  disproportionately  feeble 
organ  endangers  or  destro3^s  the  whole.  The  second 
requisite  is  freedom  from  exposure  to  the  various  casu- 
alties, indiscretions,  and  other  causes  of  disease  to  which 
illness  and  early  death  are  so  much  due." 

In  following  out  our  study  of  diseases,  we  have  been 
too  closely  narrowed  down  by  the  old  S3'mptomatic 
story  of  disease ;  we  have  too  much  treated  surface 
symptoms,  and  neglected  to  stud}'  the  man  and  his  sur- 
roundings as  a  whole  ;  we  have  overlooked  the  fact  that 
there  exists  a  geographical  fatalism  in  a  ph3'sical  sense 
as  well  as  the  existence  of  the  influence  of  that  climatic 
fatalism  so  well  described  b}'  Alfred  Haviland,  and  the 
presence  of  a  fatalism  of  individual  constitution  as  well, 
which  is  either  inherited  or  acquired.  The  idea  that 
Cliarcot  elaborates,  that,  as  the  3^ear  passes  successivel3^ 
through  the  hot  and  the  cold,  through  the  dr3'  and  the 
wet  season,  with  advancing  age  the  human  bod3'  under- 
goes like  changes,  and  diseases  assume  certain  charac- 
teristics, are  also  points  that  are  overlooked ;  and 
nowhere  is  this  latter  view  seen  to  be  more  neglected 
than  in  the  relations  the  prepuce  bears  to  infancy, 
prime  and  old  age,  as  will  be  more  full3^  explained  in 
the  chapters  in  this  book  which  treat  of  cancer  and 
gangrene.  Admitting  that  Haviland  has  exaggerated 
the  influence  of  climate  as  an  etiological  factor  in  its 
specific  influence  in  producing  certain  diseases ;  or  that 
M.  Taine  claims  more  than  he  should  for  his  "  Theorie 


16  Introduction. 

des  Milieux,"  or  influence  of  surroundings ;  or  that 
Hutchinson  has  drawn  the  hereditary-  and  pedigreeal 
fatherhood  of  disease  too  finelj- ;  it  must  also  be  ad- 
mitted that  the  solid,  tangible  truths  upon  which  these 
authors  have  founded  their  premises  are  plainl_y  visible 
to  the  most  skeptical ;  the  architectural  details  of  the 
superstructure  may  be  defective,  but  the  foundation  is 
permanent. 

From  the  above  outline  it  will  be  easier  for  the  reader 
to  follow  out  the  reasons,  or  the  Tsdiys  or  wherefores,  of 
the  views  expressed  on  medicine  in  the  course  of  the 
book;  and,  altliough  I  do  not  wish  to  enter  the  medical 
field  like  a  Peter  the  Hermit  on  a  new  crusade,  to  lure 
thousands  into  the  hands  of  the  circumcisers,  nor,  as  a 
new  Mohammed,  promise  the  eterual  bliss  and  glory  of 
tlie  seventh  heaven  to  all  the  circumcised,  I  ask  of  my 
professional  brothers  a  calm  and  unprejudiced  perusal  of 
the  tangible  and  authentic  facts  that  I  have  honestly 
gathered  and  conscientiously  commented  upon  from  my 
field  of  vision,  which  Avill  be  plainly  presented  in  the 
following  pages.  I  simplv  have  given  the  facts  aud 
m}'  impressions  :  the  reader  is  at  libertj'  to  dravr  his 
own  conclusions. 

If  1  have  been  too  tedious  in  the  multiplication  of 
incidents  in  support  of  certain  views,  I  must  remind  the 
reader  that  the  verdict  goes  to  him  who  has  the  pre- 
ponderance of  testimony,  and  that  many  a  lawsuit  is 
lost  from  the  neglect,  on  the  part  of  the  loser,  to  secure 
all  the  available  testimony.  Having  brought  the  subject 
of  circmmcision  before  the  bar  of  public  opinion,  as  well 
as  that  of  my  professional  brother,  I  would  but  illy  do 
justice  to  the  suliject  at  the  bar.  or  to  myself,  not  to 
properly  present  the  case;  as  it  was  remarked  by  Xa- 
poleon,  *•■  God  is  oil  the  side  of  the  heaviest  artillerj-,"  and. 


Introduction.  17 

he  who  loses  a  battle  for  want  of  guns  should  not  rail 
at  Providence  if,  having  them  on  hand,  he  has  neglected 
to  bring  them  into  action. 

The  reasons  for  the  existence  of  the  book  will  be- 
come self-evident  as  the  reader  labors  through  the 
medical  part  of  the  work.  Our  text-books  are,  as  a 
class,  even  those  on  diseases  of  children  as  a  specialt}', 
singularly  and  unpardonabl}^  silent  and  deficient  on  the 
subject  of  either  the  prepuce  and  tlie  diseases  to  which 
it  leads,  or  circumcision  ;  and  even  our  surgical  works 
are  not  sufficientl}^  explicit,  as  they  deal  more  with  the 
developed  disease  and  the  operative  measures  for  its 
removal  than  on  any  preventive  surgery  or  medicine. 
Our  works  on  medicine  are  equally  silent,  and,  although 
from  a  perusal  of  the  latter  part  of  the  book  the  pre- 
puce and  circumcision  will  be  seen  to  have  considerable 
bearing  on  the  production  and  nature  of  phthisis,  this 
subject  would,  owing  to  our  strabismic  way  of  studying 
medicine,  look  most  singularly  out  of  place  in  a  work 
devoted  to  diseases  of  the  lungs  or  throat.  Owing  to 
this  poverty  of  literature  on  the  subject,  and  that  the 
library  of  the  average  practitioner  could  therefore  not 
furnish  all  the  data  relating  to*  it  that  the  profession 
have  in  their  possession,  a  book  of  this  nature  will 
furnish  them  the  required  material  whereupon  to  form 
the  basis  of  an  opinion  on  the  subject. 

To  argue  that  the  prepuce  is  not  such  a  deadly  ap- 
pendage because  so  many  escape  alive  and  well  who  are 
uncircumcised,  would  be  as  logical  as  to  assume  that  Lee's 
•chief  of  artillery  neglected  to  properly  place  his  guns  on 
the  heights  back  of  Fredericksburg.  He  had  asserted, 
the  night  before  the  battle,  that  not  a  chicken  could  live 
on  the  intervening  plateau  between  the  heights  and  the 
town.     On  the  next  day,  when  these  guns  opened  their 


18  Introduction. 

fire,  the  Federals  were  unable  to  reach  the  heights,  while 
many  men  were  for  hours  in  the  iron  hail-sweeping  dis- 
charges of  that  artillery  that  mowed  them  down  by 
whole  ranks,  and  jj^et  the  majority  escaped  alive.  We 
take  the  middle  ground,  and,  while  admitting  that  many 
escape  alive  with  a  prepuce,  claim  tliat  more  are  crippled 
than  are  visibly  seen,  as,  like  Bret  Harte's  ''  Heathen 
Chinee,"  the  wa3'S  of  the  prepuce  are  dark  and  mysterious 
as  well  as  peculiar. 

A  discussion  of  the  relative  merits  of  religious  creeds, 
when  considered  in  relation  to  health,  has  been,  from  the 
nature  of  the  subject  of  the  book,  unavoidable.  Modern 
Christianit}^  but  very  imperfectly  explains  wh}^  this  rite 
was  either  neglected  or  abolished.  Frequent  reference 
is  made  to  what  Saint  Paul  said  and  did,  but,  as  Saint 
Paul  was  not  one  of  the  Disciples,  it  is  inexplicable 
wherefrom  he  received  his  authority  in  this  matter,  see- 
ing that  the  Disciples  themselves  had  no  new  views  on 
the  subject.  To  the  student  who  prefers  to  study  his 
subject  from  all  its  aspects,  the  question  naturally  arises, 
"  Where,  when,  and  wliy  came  the  authority  that  abolished 
this  rite?"  There  is  one  probable  explanation,  this 
being  that  Paul,  who  M^as  the  real  promulgator  of  Gen- 
tile Christianity,  had  to  establish  his  creed  among  an 
uncircumcised  race;  although,  as  we  shall  see,  devotees 
have  not  scrupled  to  sacrifice  their  virility  in  the  hope 
of  being  more  acceptable  to  God  and  to  be  better  able 
to  observe  His  commandments,  and  others,  in  their 
blind  bigotry,  have  not  objected  to  sitting  naked  on 
sand-hills,  with  a  six-inch  iron  ring  passed  through  the, 
prepuce,  it  is  very  evident  that  the  Apostle  Paul's  good 
sense  showed  him  the  uselessness  of  attempting  to 
found  the  new  creed,  and  at  the  same  time  hold  on  to 
the  truly  distinctive  marking  of  Judaism  among  Gen- 


Introduction.  19 

tiles,  the  Hebrew  race  being  tliose  among  wliom  he 
found  the  least  converts,  as  even  the  Disciples  and 
Apostles  in  Palestine  disagreed  with  him.  In  the  words 
of  Dr.  I.  M,  Wise,  it  was  impossible  for  the  Palestine 
Apostles,  or  their  flock,  either  to  acknowledge  Paul  as 
one  of  their  own  set  or  submit  to  his  teaching ;  for  they 
obe^-ed  the  Law  and  he  abolished  it ;  they  were  sent  to 
the  house  of  Israel  onlj"^,  and  Paul  sought  the  Gentiles 
with  the  message  that  the  Covenant  and  the  Law  were  at 
an  end ;  tbey  had  one  gospel  story  and  he  another ; 
they  prophesied  the  speedy  return  of  the  Master  and  a 
restoration  of  the  throne  of  David  in  the  kingdom  of 
heaven,  and  he  prophesied  the  end  of  the  world  and  the 
last  day  of  judgment  to  be  at  hand  ;  they  forbade  their 
converts  to  eat  of  unclean  food,  and  especially  of  the 
sacrificial  meats  of  the  Pagans,  and  he  made  light  of 
both,  as  well  as  of  the  Sabbath  and  circumcision.  In 
the  attempted  reconciliation  that  subsequently  took 
place  in  Jerusalem  at  the  house  of  James,  the  Jacob  of 
Kaphersamia  of  the  Talmud,  Paul  was  charged  by  the 
synod  of  Jewish  Christians  "  with  disregarding  the  Law, 
forsaking  the  teachings  of  Moses,  and  attempting  to 
abolish  circumcision."  He  was  bid  to  recant  and  un- 
dergo humiliation  with  four  other  Nazarenes,  that  it 
might  be  known  that  he  walked  orderly  and  ob- 
served the  Law ;  Paul  submitted  to  all  that  was  de- 
manded. 

This,  in  short,  with  the  exception  of  the  sayings  of 
Paul  on  the  subject,  which  are  all  secondary  con- 
siderations, is  really  all  that  there  is  relating  to  the 
abolishment  of  circumcision  by  the  Christians.  The 
real  Disciples  and  Apostles  believed  in  Jesus  with  as 
much  fervor  as  Paul,  but  it  is  singular  that  the}'^  who 
were  with  the  Master  should  always  have  insisted  on  the 


20  Introduction. 

observance  of  the  Law,  while  Paul  as  energetically 
insisted  on  its  abolishment. 

From  these  premises,  I  have  seen  J5t  to  inquire  into 
the  relative  merits  of  the  three  religions  practiced  by 
what  we  call  the  civilized  nations,  as  they  aflect  man 
morally,  physically,  and  mentally.  I  have  given  the  tacts, 
my  impressions,  and  reasons  for  being  so  impressed  ;  from 
these,  the  reader  can  easily  see  that  religion  has  more  to 
do  with  man's  temporal  existence  than  is  generally 
believed  ;  its  discussion  is  not,  therefore,  out  of  place  in 
this  book. 

Repetitions  in  the  course  of  the  work  have  been 
unavoidable.  This  is  not  a  novel  nor  a  work  of  fiction, 
and  wherever  the  want  of  repetition  would  have  been  an 
injury,  either  to  the  proper  representation  of  a  fact  or  a 
principle,  the  repetition  has  not  been  avoided.  In 
describing  the  opei'ations,  I  had  desired  to  avoid  any  too 
numerous  descriptions,  as  that  is  confusing,  but  have 
thought  it  best  to  give  a  number,  as  the  reader  will 
thereby  obtain  the  views  of  the  different  operators,  the 
mode  of  the  operation  often  being  an  index  to  the  view 
of  the  .operator  in  regard  to  the  needs  or  utility  of  a 
prepuce.  In  the  general  plan  of  the  work,  I  have 
adopted  the  idea  and  the  historical  relation  carried  out 
by  Bergmann,  of  Strasburg,  who  included  all  the  mutila- 
tions practiced  on  the  genitals  while  discussing  the 
subject  of  circumcision,  they  being,  in  the  originalitj'  of 
performance,  somewhat  intimately  connected  ;  this  also 
tends  to  make  the  subject  more  interesting  as  a  con- 
tribution to  the  natural  history  of  man, — something  in 
which  all  intelligent  persons  are  more  or  less  interested. 

P.  C.  Remondino,  M.D. 

San  Diego,  Califobnia. 


A  HISTORY  OF  CIRCUMCISION. 


CHAPTER  I. 

Antiquity  of  Circumcision. 


If  the  ceremonials  of  the  Catholic  Church  or  the 
High  Church  Episcopalians  carry  us  back  into  the  depths 
of  antiquity,  or,  as  remarked  hy  Frothingham,  that  the 
ceremonies  of  St.  Peter,  at  Rome,  carried  him  back  to 
the  mysteries  of  Eulesis,  to  the  sacrificial  rites  of 
ancient  Phoenicia,  to  what  misty  antiquity  does  not  the 
contemplation  of  the  rite  of  circumcision  take  us?  The 
Alexandrian  library,  with  its  vast  collection  of  precious 
records,  could  probably  have  furnished  us  some  informa- 
tion as  to  its  origin  and  antiquitj' ;  but  Moslem  fanati- 
cism, with  its  belief  in  the  all-sufficiency  and  infallibility 
of  the  Koran,  was  the  destruction  of  that  wonderful 
repository.  We  must  now  depend  wholly  on  the  rela- 
tion of  the  Old  Testament  or  on  what  has  since  been 
Written  by  the  Greek  and  Italian  historians  as  to  its 
origin  and  practices.  The  Egyptian  monuments  and 
their  hj'eroglyphics  give  us  no  information  on  the  sub- 
ject further  back  than  the  reign  of  Rameses  II ;  while  the 
oft-quoted  Herodotus  wrote  some  fourteen  centuries  after 
the  Old  Testament  relation,  and  Strabo  and  Diodorus 
some  nineteen  centuries  after  the  same  chronicler.  We 
have,  therefore,  in  their  chronological  order,  first,  the 
relation  of  the  Bible  ;  then  the  Eg3fptian  monuments  and 
their  revelations;  and,  thirdly,  the  information  gathered 
by  Pythagoras,  Herodotus,  and  other  philosophers  and 

(21) 


22  Hidory  of  Circumcision. 

historiiins.  To  these  three  sources  we  may  add  the 
misty  mixture  of  tradition  and  mythological  events, 
whose  beginnings  as  to  period  of  time  are  indefinite. 
These  are  the  sources  from  which  we  are  to  determine 
tlie  origin  and  antiquity  as  well  as  the  character  of  the 
rite. 

Voltaire  found  in  the  subject  of  circumcision  one 
that  he  could  not  satisfactorily  make  enter  into  his  pecu- 
liar s^'stem  of  general  philosophy.  For  some  reason,  he 
did  not  wish  that  the  Israelites  should  have  the  credit 
of  its  introduction  ;  were  he  to  have  admitted  that,  he 
would  have  had  to  explain  away  the  divine  origin  of 
the  rite, — something  that  the  Hebrew  has  tenaciously 
lield  for  over  thirty-seven  centuries.  Yoltaire  thought 
it  would  simplify  the  subject  by  making  it  originate 
with  the  Egyptians,  from  whom  the  Hebrews  were  to 
borrow  it.  To  do  this  he  adopted  the  relation  of  Hero- 
dotus on  the  subject.  His  treatment  of  the  Jewish 
race,  however,  brought  out  a  strong  antagonism  from 
tliose  people  to  his  attacks,  and  in  a  volume  entitled, 
"  Letters  of  Certain  Jews  to  Monsieur  Voltaire," — being 
a  series  of  criticisms  on  his  aspersions  on  the  race  and 
on  the  writings  of  the  Old  Testament  (written  by  a 
number  of  Portuguese,  German,  and  Polish  Jews  then 
residing  in  Holland^), — they  pi'oved  conclusiA^ely  that 
the  Phoenicians  had  borrowed  the  rite  from  the  Israel- 
ites, as  tliey  (the  Phoenicians)  had  practiced  the 
rite  on  the  newborn,  whereas,  had  they  followed  the 
Egyptian  rite,  they  would  have  only  circumcised  the 
cliild  after  its  having  passed  its  thirteenth  year, — these 
being  the  distinctive  differences  between  the  Jewish  and 
Egyptian  ritea. 

Luckily,  in  the  small  temple  of  Khons,  which  formed 
an  annex  to  the   greater  temple  of  Maut,  at  Karnac, 


Antiquity  of  Circumcision.  23 

there  was  found  a  bas-relief,  partly  perfect,  "vvhicli  goes 
far  toward  giving  light  on  the  subject  of  Eg\yptian  cir- 
cumcision. The  upper  part  of  the  sculpture  was  so 
defaced  that  the  upper  portions  of  four  of  the  five  figures 
were  destroyed,  but  the  lower  portions  were  so  perfect 
in  every  detailas  to  furnish  a  full  history  of  the  age  of 
the  candidates  for  the  rite  and  the  manner  of  its  per- 
formance. It  is  further  interesting  from  the  fact  that 
it  establishes  also  the  time  during  which  the  rite  was  so 
performed.  M.  Chabas  and  Dr.  Ebers  argue,  from  the 
founder  of  the  temple  having  been  Rameses  II,  that 
the  sculpture  refers  to  the  circumcision  of  two  of  his 
children.  The  knife  appears  to  be  a  stone  implement, 
and  the  operator  kneels  in  front  of  the  child,  who  is 
standing,  while  a  matron  supports  him  in  a  kneeling 
posture,  and  she  holds  his  hands  from  behind  hira.^  In 
this  bas-relief  we  can  see  the  great  difference  that  ex- 
isted between  the  two  forms  of  the  operation,  that  of 
the  Hebrews  being  performed,  as  a  rule,  on  the  eighth 
day  after  birth,  while  in  the  bas-relief  they  are  ten  or 
twelve  3'ears  old. 

Although  tradition  and  mythology  veil  past  events 
in  more  or  less  obscuritj^,  they  do,  in  regard  to  circum- 
cision, furnish  considerable  explanatory  light  on  mattei's 
which  would  be  otherwise  hard  to  reconcile.  Circum- 
cision has  been  performed  by  the  Chippeways,  on  the 
Upper  Mississippi,  and  its  modifications  were  performed 
among  the  Mexicans,'  Central  Americans,  and  some 
South  American  tribes  of  Indians,  as  well  as  among 
many  of  the  natives  dwelling  among  the  islands  of  the 
Pacific  Archipelago.  There  is  a  tradition,  mentioned 
by  Donnelly  in  connection  with  the  sunken  continent  of 
Atlantis,  that  Ouranos,  one  of  the  Atlantean  kings, 
ordered   his  whole   army  to  be  circumeised  that   they 


24  History  of  Circumcision. 

might  escape  a  fatal  scourge  then  decimating  the  people 
to  their  westward.^  This  tradition  tells  us  that  the 
hygienic  benefits  of  circumcision  were  recognized  ante- 
diluvian facts,  as  it  also  points  out  the  way  by  which 
circumcision  traveled  westward  across  to  tlie  Western 
World.  As  Donnelly  has  pointed  out,  man}-  of  the 
Americans  possessed  not  onl}'  traditions,  habits,  and 
customs  that  must  have  come  from  the  Old  World,  but 
the  similarity  of  many  words  and  their  meaning  that 
exists  between  some  of  the  American  languages  and 
those  of  the  indigenous  inhabitants  that  have  still  their 
remains  in  spots  on  the  southwestern  shores  of  Europe- 
— the  ancient  Armorica  whose  colony  in  Wales  still 
retains  its  ancient  words — leaves  no  room  for  doubt  that 
at  ona  time  a  landed  higliway  existed  between  the  two 
worI(!lst  The  Mandans,  on  tlie  Upper  Missouri,  have 
many  words  of  undoubted  Armorican  origin  in  their 
vocabulary,*  just  as  the  Ghiapenec,  of  Central  America, 
contains  its  principal  words  denotive  of  deitj^  family 
relations,  and  many  conditions  of  life  that  are  identi- 
cally the  same  as  in  the  Hebrew,^  the  name  of  father, 
son,  daughter,  God,  king,  and  rich  being  essentially  the 
same  in  the  two  languages.  It  must  have  been  more 
than  a  passing  coincidence  that  gives  the  Mandans  some 
of  their  most  expressive  words  from  the  Welsh,  or  that 
gave  to  Central  America  many  cities  bearing  analogous 
names  with  the  cities  of  Armenia.^  Canadian  names  of 
localities,  as  well  as  those  of  the  Mississippi  Yallej^ 
denote  the  French  origin  of  their  pioneers,  as  well  as 
the  names  of  Upper  California  denote  the  nationality 
and  creed  of  its  first  settlers.  So  that  there  is  nothing 
strange  in  asserting  that  American  civilization  and 
many  of  the  customs  as  found  in  the  fifteenth  century 
by  the  early  Spanish   discoverers  were  nothing  more 


Antiquity  of  Circumcision.  25 

than  the  remains  of  ancient  and  modified   Phoenician 
civilization,  among  which  figured  circumcision. 

Dr.  A.  B.  Arnold,  of  Baltimore,  argues  that,  with  the 
present  state  of  our  anthropological  knowledge  and  the 
material  that  research  has  been  able  to  furnish,  we  need 
no  longer  be  surprised  to  find  customs,  laws,  and  morals, 
among  nations  living  in  regions  of  the  world  widely 
apart  from  each  other,  which  betray  an  identity  of  origin 
and  development,  and  that  beliefs  and  institutions, 
whether  wise  or  aberrant,  grow  up  under  apparently 
dissimilar  circumstances,  circumcision  forming  no  ex- 
ception.'^ Dr.  Arnold  leaves  too  much  to  chance.  It  is 
hardly  likely  that  the  similarity  that  existed  between 
the  architecture  of  the  Phoenicians  and  the  Central 
Americans,  as  evinced  in  their  arches ;  in  the  beginning 
of  the  century  on  the  26th  of  February ;  the  advance- 
ment and  intei'est  taken  in  astronomical  science  ;  the 
coexistence  of  pyramids  in  Egj'pt  and  Central  America  ; 
that  five  Armenian  cities  should  have  their  namesakes 
in  Central  America,  should  all  be  a  matter  of  accident. 
The  historiographer  of  the  Canaiy  Islands,  M.  Benshalet, 
considers  that  those  islands  once  formed  a  part  of  the 
great  continent  to  its  west ;  this  has  been  verified  by  tlie 
discovery  of  many  sculptured  s^'mbols,  similar  in  the 
Canaries  and  on  the  shores  of  Lake  Superior,  as  well  as 
by  the  discovery  of  a  mummy  in  the  Canaries  with  san- 
dals whose  exact  counterparts  were  found  in  Central 
America.*  A  compound  word  used  to  signify  the  Great 
Spirit  being  found  identical  in  the  Welsh  and  Mandan 
languages,  each  requiring  five  distinct  sounds  to  pro- 
nounce, words  as  intricate  as  the  passwords  of  secret 
societies,  can  hardly  be  said  to  be  the  result  of  chance.^ 
There  must,  at  some  remote  period,  have  existed  some 
communication  between  the  ancestors  of  these  Missouri 


26  History  of  Circumcision. 

Maudans  aud  the  shoves  of  ancient  Annorica  :  the  ances- 
tors of  these  Maudans  may  have  then  been  living  farther 
to  the  east;  they  even  may  have  then  been  a  tribe  of 
since  lost  Atlantis:  but  the  analogy,  not  only  in  regard 
to  the  word  jnst  irienti'.'ned. — M:r'>o-y C'li^'o..  of  the  Welsh 
and  Mandan. —  ;jut  in  the  similarity  ot  tiie  pronouns  of 
both  languages,  aud  the  existence  of  the  idea  of  the 
c<:i;r.;:-:  ;■:  rr  of  the  sacred  white  ball  of  the  Egyptians 
l.'L-:;"i_  :''j;in  .1  arnoug  the  Dakotas.  or  Sioux,  all  point  to  the 
fact  ti:at  these  people,  in  common  with  the  rest  of  the 
Americans,  originallj  came  from  the  East  :  from  whence 
came  their  languages,  manners,  customs,  rites,  and  what 
civilization  tliey  possessed,  among  wliicli  circumcision 
iias.  tlirongli  the  mist  of  centuries,  held  its  own  in  i^ijme 
shape  or  otiier. 

That  -"n;^  ttrrrii/.e  catastrophe  occurred  to  divide 
the  hemispheres  is  eviderit  :  the  "Western  World  remain- 
ing stationary  in  its  civilization  and  retaining  the 
customs  ay:  1  r;' ■-  of  the  times  as  evidence  of  their 
origin.  W.rii  r^;^  view  of  the  case,  the  existence  of 
circumcision  as  found  among  the  inhabitants  of  the 
West  can  easily  be  trace^l  to  its  origin  among  the  hills 
of  Chaldea.  The  ancient  traditions  and  m^'thological 
relations  of  the  Eg^^ptians  in  regard  to  the  great  nation 
to  the  West  are  amply  verified  by  the  deep-sea  soundings 
of  the  "  Challenger,"  the  "Dolphin,"  and  the  •  Gazelle.'' 
which  plainly  indicaie  the  presence  of  a  sul'^marine 
plateau  that  once  formed  the  continent  of  Atlantis, 
whose  only  vis;l:iie  evi.lenee  alx>ve  the  waves  of  the 
boisterous  Atlay.v'>:  i-  t'.,f;  Az^a-es  au'l  the  remains  of 
Phoenician  civilizuti-ju  amoijg  the  Americans. 

Professor  Worman.  of  Brooklyn,  scouts  the  idea  that 
cir':"v:";;''''-:':'ri  wli-,  ever  connected  in  an}'  wny  or  that  it 
origirjatc'i  m  anv  of  the  rites  connected   with   phallic 


Antiquity  of  Circumcision.  27 

worship.^''  Bergmann,^^  of  Strasbnrg,  however,  not 
Gill}'  claims  circumcision  to  be  a  direct  result  of  phallic 
worship,  but  looks  upon  the  rite  as  something  that  has 
been  reached  by  what  maybe  termed  a  gradual  evolution- 
ary process  of  manners,  customs,  and  society,  from  the 
time  of  what  is  termed  the  hero-warrior  period  of  tradi- 
tional historj^,  when  war  and  the  clashing  of  shields  and 
sword  or  spear  were  the  main  delights  and  occupations  of 
man.  It  is  strange  to  note  what  difference  must  have  ex- 
isted between  these  hero-warriors  in  regard  to  their  ideas 
of  manliness;  some  were  brutal  and  fiendish,  whilst  others 
were  magnanimous.  McPherson,  the  historiographer  of 
early  Britain,  cannot  help  but  contrast  the  superior 
manliness  of  the  heroes  of  Ossian  in  his  graphic  descrip- 
tion of  the  ancient  Caledonians,  when  compared  to  the 
brutality  of  Homer's  Greek  heroes.  The  traditions 
upon  which  Bergmann  undertakes  to  found  the  origin 
of  the  rite  of  circumcision  are  all  connected  with  the 
inhuman  and  brutish  passions  that  animated  our  bar- 
barous ancestry.  The  first  incident  given  is  the  Egyptian 
traditional  tragedy,  which  was,  in  all  probabilit}',  the 
initial  point  of  that  phallic  worship  which,  with  increas- 
ing debauchery,  assisted  in  the  final  demoralization  of 
Rome  and  Greece,  after  its  introduction  into  those 
countries. 


CHAPTER  11. 

Theories  as  to  the  Origin  of  Circumcision. 

We  are  told  that  in  battle  man  looked  upon  the 
vanquished  as  unfit  to  bear  the  name  of  man,  looking 
•  upon  the  weakness  or  want  of  skill  which  contributed 
to  their  defeat  as  something  effeminate.  The  victor  then 
proceeded  by  a  very  summary  and  effective  mode,  done 
in  the  most  primitive  and  expeditious  manner,  to  render 
his  victim  as  much  like  a  female  as  possible  to  all  out- 
ward appearances ;  this  was  accomplished  by  a  removal 
at  one  sweep  of  aZZ  the  organs  of  generation,  the  phallus 
being  generally  retained  as  a  trophy, — a  practice  which 
was  also  carried  into  effect  with  dead  enemies,  to  show 
that  the  victor  had  vanquished  men.  It  has  been  the 
practice  from  time  immemorial  for  a  victor  to  carry  off 
some  portion  of  the  body  of  his  victim  or  defeated 
enemy,  as  a  mark  or  testimony  of  his  prowess  ;  it  was 
either  a  hand,  head  or  scalp,  lower  jaw,  or  finger.  The 
carrying  off  of  the  phallus  or  virile  member  was  con- 
sidered the  most  conclusive  proof  of  the  nature  of  the 
vanquished,  and,  as  it  established  the  sex,  it  conferred 
a  greater  title  to  bravery  and  skill  than  a  mere  collection 
of  hands  or  scalps,  which  would  not  denote  the  sex.  In 
conformity  with  this  custom,  we  find  that  Osiris,  when  he 
returned  to  Egypt  and  found  that  Typhon  had  fomented 
dissension  in  his  absence,  being  vanquished  by  the  latter 
in  the  conflict  that  followed,  was  dismembered  and  cut 
into  pieces,  the  followers  of  Typhon  each  securing  a 
piece  and  Typhon  himself  securing  the  phallus  or  gen- 
erative member.  Isis,  the  spouse  of  Osiris,  seems  in 
turn  to  have  secured  the  control  of  government,  and, 
(28) 


Tlieories  as  to  the  Origin  of  Circumcision.         29 

having  secured  all  the  pieces  of  the  dissected  Osiris 
except  the  phallus, — Typhon  having  fled  with  that,  and, 
according  to  some  traditions,  having  thrown  it  into  the 
sea, — Isis  ordered  that  statues  should  be  constructed, 
each  to  contain  a  piece  of  the  unfortunate  Osiris,  who 
should  thereafter  be  worshiped  as  a  god,  and  that  the 
priestliood  should  choose  from  among  the  animals  some 
one  kind  which  should  thereafter  be  considered  sacred. 
The  phallus  which  was  missing  was  ordered  special  wor- 
ship, with  more  marked  solemnities  and  mysteries  ;  from 
this  originated  the  phallic  worship  and  the  sacredness  of 
the  white  bull,  Apis,  among  the  Egyptians,  which  was 
chosen  to  represent  Osiris. 

By  gradual  evolution  and  the  progress  of  society, 
the  cultivation  of  the  ground  and  the  need  of  menials, 
warriors  found  some  other  use  for  their  prisoners  taken 
in  strife  besides  merely  cutting  off  the  phallus  as  a 
trophy;  these  prisoners  began  to  have  some  intrinsic 
value.  From  this  a  change  came  about ;  the  warrior  in- 
stinct, however,  still  claimed  that  the  vanquished,  even 
if  a  slave,  should  still  convey  or  carry  some  sign  of  ser- 
vitude. The  original  idea  of  the  ablation  of  the  phallus 
was  to  emasculate  the  victim  ;  investigation  developed 
the  idea  that  the  same  object  could  be  accomplished  by 
castration,  an  operation  which  also  finally  reached  a 
tolerable  state  of  perfection  through  different  stages  of 
evolution,  it  first  being  performed  by  a  complete  re- 
moval of  the  whole  sci'otum  and  contents.  This  opera- 
tion, with  the  ignorance  of  the  times  in  regard  to 
stopping  hfemorrhage,  was,  however,  accompanied  by  a 
large  mortality,  and  it  finally  evolved  into  the  simple 
removal  of  the  gland,  or  its  obliteration  by  pressure 
or  violence.  Bergmann  conveys  the  idea  that  circum- 
cision was  at  one  time  the  indestructible  marking  and 


30  History  of  Circumcision. 

the  distinctive  feature  of  tlie  slave,  the  mind  of  the 
period  not  being  able  to  emancipate  itself  from  the  idea 
that  the  genitals  must  in  some  manner  be  mutilated,  not 
being  able  to  conceive  an}^  other  degrading  mark  of 
manhood  which  barbarians  felt  they  must  iuflict  on 
slaves. 

The  generally-  accepted  idea  in  regard  to  the  physical 
mutilation  of  captives  taken  in  war,  or  that  some  token 
from  the  body  of  the  vanquished  must  be  carried  oft'  by 
the  victor,  has  not  onl^^  the  support  of  tradition  and 
monumental  sculptured  evidence,  but  its  practice  is  still 
in  vogue  among  man}"  races.  Among  the  ancient 
Scythians,  only  the  warriors  who  returned  from  the 
battle  or  foray  with  the  heads  of  the  enemj-  were  en- 
titled to  a  share  in  the  spoils.  Among  the  modern 
Berbers  it  is  still  a  practice  for  a  j'oung  man,  on  propos- 
ing marriage,  to  exhibit  to  his  prospective  father-in-law 
the  virile  members  of  all  the  enemies  he  has  overcome, 
as  evidence  of  his  manhood  and  right  to  the  title  of 
warrior.  The  Abyssinians  and  some  of  the  negro  tribes 
on  the  Guinea  coast  still  follow  the  custom  of  securing 
the  phallus  of  a  fallen  foe.  However  barbarous  this 
l)ractice  maj'  seem,  its  actual  performance  is  only  sec- 
ondar}",  the  primary'  motive  being  that  the  warrior 
wished  to  prove  that  he  had  been  there,  engaged  in 
actual  strife,  and  that  his  enem}^  had  been  overcome. 
The  writer  remembers  that,  after  one  of  the  battles  in 
the  West  during  the  late  war,  man^'^  letters  arrived  in 
his  locality  with  pieces  of  the  garments  or  locks  of 
the  hair  of  the  unfortunate  Confederate  general,  Zolli- 
koff"er,  who  had  been  slain  in  the  battle ;  a  disposition  in 
the  warrior,  seemingly  still  existing,  such  as  animated 
the  old  Egyptians.  On  an  old  Egyptian  monument, — 
that  of  Osj-mandyas, — Diodorus  noticed  a  mural  sculp- 


Theories  as  to  the  Origin  of  Circumcision.         31 

tare,  a  bas-relief  representing  prisoners  of  war,  either 
in  cliains  or  bound  with  cords,  being  registered  by  a 
royal  scribe  preparatory  to  losing  either  the  right  hand 
or  the  phallus,  a  pile  of  which  is  visible  in  one  corner 
of  the  foreground  ;  from  this  sculpture  we  learn  that  the 
practice  was  not  only  an  individual  performance,  but 
that  it  was  a  national  usage  among  the  Egyptians  as 
well,  who  subjected,  at  times,  their  vanquished  foes  to 
its  ordeal  in  a  wholesale  but  business-like  manner. 

Bergraann  argues  that  the  Israelites  were  given  to 
like  practices,  and  cites  the  incident  wliereiu  David 
brought  two  hundred  prepuces — as  evidence  of  his  liav- 
ing  slaughtered  that  number  of  Philistines — to  Saul,  as 
a  mark  of  his  being  worthy  to  be  his  son-in-law.  He 
argues  that,  whereas  many  have  made  that  Old  Testa- 
ment passage  to  read  "  two  hundred  prepuces,"  it  should 
have  read  "  two  hundred  virile  members ''  wliicli  David 
and  his  companions  had  cut  off  from  tl»e  Philistines,  the 
word  07^loth  meaning  the  virile  member,  and  not  the 
prepuce.  Tliat  Israelitish  circumcision  could  have 
originated  from  either  phallic  worship  or  any  of  the 
hero-warrior  usages  is  untenable  as  a  proposition,  as 
regards  the  living  prisoners,  and  is  contrary  to  the 
monotheistic  idea  wliich  ruled  Israel,  or  to  the  benign 
nature  of  their  God.  The  strict  opposition  of  the 
religion  of  Judaism  to  any  otlier  mutilation  except  that 
of  the  covenant  is  also  antagonistic  to  tlie  views 
advanced  by  Bergmann,  as  it  is  well  known  that  even 
emasculated  animals  were  considered  imperfect  and 
unclean,  and  therefore  unfit  to  be  received  or  offered  as 
a  sacrifice  to  their  deity.  No  emasculated  man  was 
allowed  to  enter  the  priesthood  or  assist  at  sacrifices. 
The  whole  idea  of  Judaism  being  opposed  to  such 
mutilations,  their  observance  of  circumcision  and  its 

2 


32  History  of  Circumcision. 

performance  can  in  no  way  have  developed  from  either 
phallic  or  other  warlike  rites  or  usages ;  but  we  must 
accept  its  origin  as  a  purely  religions  rite, — a  covenant 
of  the  most  rigid  observance,  coincident  in  its  inception 
with  the  formation  of  the  Hebraic  creed  in  the  hills  of 
Chaldea. 

What  Herodotus  or  Pythagoras  may  have  written 
concerning  tlie  practice  among  tlie  Egyptians  was 
written,  as  already  remarked,  some  nine  centuries  after 
Moses  had  recorded  his  laws ;  Moses  himself  having 
come  some  centuries  after  Abraham.  Herodotus  is 
quoted  as  representing  that  the  Phoenicians  borrowed 
the  practice  from  the  Egyptians,  in  support  of  the  theory 
that  Eg3'pt  was  tlie  central  nucleus  from  whence  the 
practice  started,  and  not  that  it  traveled  toward  Egj'pt 
from  Phoenicia.  The  difference  in  the  ages,  already 
mentioned,  at  which  the  rite  was  practiced — that  of 
Phoenicia  and  Israel  being  at  one  time  identical — shows 
that  the  testimony  of  Herodotus  in  this  one  particular 
was  the  result  of  faulty  judgment,  as  we  find  the  people 
who  have  borrowed  the  practice  from  the  Egyptians,  as 
well  as  their  descendants,  closel}'  follow  their  practice 
in  regard  to  the  age  at  which  the  operation  should  be 
performed.  Another  evidence  of  tlie  strictly  religious 
nature  of  the  rite,  as  far  as  the  Hebrews  are  concerned, 
lies  in  the  fact  that,  with  all  their  skill  in  surgery  and 
medical  sciences, — they  being  at  one  time  the  only  intel- 
ligent exponents  of  our  science, — they  never  made  any 
alteration  or  improvement  in  tlie  manner  of  performing 
the  operation.  It  is  evident  that  even  Maimonides,  a 
celebrated  Jewish  ph3'sician  of  the  twelfth  centuiy,  who 
furnished  some  rules  in  regard  to  the  operation,  was 
held  under  some  constraint  \)y  the  religious  aspect  of 
the  rite.     As  a  summary  of  this  part  of  the  subject,  it 


Theories  as  to  the  Origin  of  Circumcision.         33 

ma}^  be  stated  that  the  Old  Testament  furnished  tlie 
only  reliable  and  authentic  relation  prior  to  Pythagoras 
and  Herodotus.  From  its  evidence,  Abraham  was  the 
first  to  perform  the  operation,  which  he  seems  to  have 
performed  on  himself,  his  son,  and  servants, — in  all, 
numbering  nearly  four  hundred  males  ;  he  then  dwelt  in 
Chaldea.  In  absence  of  other  as  reliable  evidence  we 
must  accept  this  testimony  in  regard  to  its  origin, 
causes,  and  antiquity. 

Voltaire,  in  his  article  on  circumcision  in  his  "  Philo- 
sophical Dictionar}^,"  seems  more  intent  on  breaking 
down  an3'  testimony  that  might  favor  belief  in  any 
religion  than  to  impart  any  useful  light  or  information. 
He  bases  all  his  argument^  on  the  book  "Euterpe,"  of 
Herodotus,  wherein  he  relates  that  the  Colchis  appear 
to  come  from  Egypt,  as  the}'  remembered  the  ancient 
Egyptians  and  their  customs  more  than  the  Egyptians 
remembered  either  the  Colchis  or  their  customs  ;  the 
Colchis  claimed  to  be  an  Egyptian  colon}^  settled  there 
by  Sesostris  and  resembled  the  Eg3'ptians.  Voltaire 
claims  that,  as  the  Jews  were  then  in  a  small  nook  of 
Arabia  Petrea,  it  is  hardly  likely  that,  they  being 
then  an  insignificant  people,  the  Eg^^ptians  would  have 
borrowed  any  of  their  customs.  To  read  Voltaire's 
"  Herodotus  "  is  somewhat  convincing,  but  Voltaire's 
''Herodotus "  and  Herodotus  writing  liimself  are  two 
different  things,  and  the  book  "Euterpe"  saj^s  quite 
another  thing  from  what  M.  Voltaire  makes  it  say.  A 
perusal  of  Voltaire  and  a  study  of  his  Jewish  critics  on 
this  subject,  as  found  in  the  "Jews'  Letters  to  Vol- 
taire," will  convince  any  reader  that  as  to  circumcision 
M.  Voltaire  is  an  unreliable  authority. 


CHAPTER  III. 

Spread  of  Circumcision. 

From  Chaldea,  then,  in  the  mountains  of  Armenia 
and  Kurdistan,  the  practice  of  circumcision  was,  in  all 
probability^,  first  adopted  by  the  Plioenicians,  who  finally 
relinquished  the  Israelitish  rite  as  to  age  of  performance 
and  exchanged  it  for  the  Egyptian  rite.  From  Phoenicia 
its  spread  through  the  maritime  enterprises  of  this  race 
to  foreign  parts  was  easy.  Egypt  was  the  next  place  to 
adopt  its  practice ;  at  first  the  priesthood  and  nobility, 
which  included  royalty,  were  "the  only  ones  who  availed 
themselves  of  the  practice.  The  Egyptians  connected 
circumcision  with  hygiene  and  cleanliness;  this  was  the 
view  of  Herodotus,  who  looked  upon  the  rite  as  a  strictly 
hygienic  measure.  History  relates  of  the  existence  of 
circumcision  among  the  Egyptians  as  far  back  as  the 
reign  of  Psammetich,  who  ruled  toward  tlie  end  of  the 
sixth  century  B.C.  The  practice  must  then  have  been 
of  a  very  religious  and  national  nature,  as  we  are  told 
that  Psammetich,  having  admitted  some  noted  strangers, 
whom  he  allowed  to  dwell  in  Egj^pt  without  being  cir- 
cumcised, brought  himself  into  great  disfavor  among 
his  subjects,  and  especially  by  the"  army,  who  looked 
upon  an  uncircumcised  stranger  as  one  undeserving  of 
favors.  During  the  next  century  Pythagoras  visited 
Egypt,  and  was  compelled  to  submit  to  be  circumcised 
before  being  admitted  to  the  privilege  of  studj-ing  rn 
the  Egyptian  temples.  In  the  following  century  these 
restrictions  were  removed,  for  neither  Herodotus  nor 
Diodorus,  who  visited  the  country,  were  obliged  to  be 
(34) 


Spread  of  Circumcision.  35 

circumcised,  either  to  dwell  among  the  people  or  to 
follow  their  studies.  There  is  one  curious  habit  that  is 
mentioned  in  connection  with  the  rite  of  circumcision 
among  these  people,  this  being  its  relation  to  the  taking 
of  an  oath  or  a  solemn  obligation.  Among  the  Egyptians 
the  circumcised  phallus,  as  well  as  the  rite  of  circum- 
cision, seemed  to  be  the  symbol  of  the  religious  as  well 
as  of  the  political  community,  and  the  circumcised 
member  was  emblematical  of  civil  patriotism  as  well  as 
of  the  orthodox  religion  of  the  nation.  To  the  Egyptian, 
his  circumcised  phallus  was  the  symbol  of  national  and 
religious  honor ;  and  as  the  Anglo-Saxon  holds  aloft  his 
right  hand,  with  his  left  resting  on  the  holy  Bible,  while 
taking  an  oath,  so  the  ancient  Egyptian  raised  his  cir- 
cumcised phallus  in  token  of  sincerity, — a  practice  not 
altogether  forgotten  by  his  descendants  of  to-day.  It 
was  partly  this  custom  of  swearing,  or  of  affirming,  with 
the  hand  under  the  thigh,  by  the  early  Israelites,  that 
caused  many  to  believe  that  their  circumcision  was  bor- 
rowed from  the  Egyptians,  especially  by  M.  Voltaire, 
who  insists  that  it  was  the  phallus  that  the  hand  was 
placed  on,  and  that  the  translation  has  not  the  proper 
meaning,  as  given  in  the  Bible. 

Among  the  Arabs  it  was  the  practice  to  circumcise 
at  the  age  of  thirteen  years,  this  being  the  age  of 
Ishmael  at  his  circumcision  by  his  father,  Abraham. 
The  Arabs  practiced  circumcision  long  before  the  advent 
of  Mohammed,  who  was  himself  circumcised.  Pococke 
mentions  a  tradition  which  ascribes  to  the  prophet  the 
words,  "  Circumcision  is  an  ordinance  for  men,  and  hon- 
orable in  women."  Although  the  rite  is  not  a  religious 
imposition,  it  has  spread  wherever  the  crescent  has 
carried  the  Mohammedan  faith.  Uncircumcision  and 
impurity  are  to   a    Mohammedan    sj-nonymous   terms. 


36  History  of  Circumcision. 

Like  the  Abyssinians,  the  Arabs  also  practice  female 
circumcision, — an  operation  not  without  considerable 
medical  import,  as  will -be  explained  in  the  medical  part 
of  the  work.  This  practice  is  also  common  in  Ethiopia. 
Some  authorities  argue,  from  this  association  of  female 
circumcision  among  the  Southern  Arabs,  Ethiopians, 
and  Abyssinians,that  they  did  not  derive  their  rite  from 
the  Israelites ;  but  there  is  not  much  room  for  doubt 
but  that  the  operation  came  down  to  the  Arabians  from 
Abraham  through  his  son  Ishmael.  Considering  the 
occupancy  of  Syria,  Arabia,  and  Egypt  by  the  French, 
and  the  intercourse  with  these  countries  by  tlie  British, 
it  is  surprising  that  the  profession  in  the  early  part  of 
the  present  century  had  not  full  information  regarding 
the  nature  and  objects  of  female  circumcision  as  prac- 
ticed in  these  countries.  Delpesh  observes,  in  relation 
to  the  Oriental  practice,  that  his  information  was  too 
vague  to  determine  whether  it  was  the  nymphae  or  tlie 
clitoris  that  were  removed,  or  whether  it  was  only  prac- 
ticed in  cases  of  abnormal  elongations  of  these  parts. 
M.  Murat,  however,  writes  at  length  on  the  subject,  \Q\-y 
intelligently,  as  well  as  Lonyer-Yillermaj^  who,  writing 
in  the  same  work  with  Delpesh,  thinks  it  is  certainly 
the  clitoris  that  is  removed.^^  In  Arabia,  the  trade  or 
profession  of  a  resectricis  nyvipharum  or  she-circum- 
ciser  is  as  stable  an  occupation  with  some  matrons  as 
that  of  cock-castration  or  caponizing  is  the  sole  occupa- 
tion of  many  a  matron  in  the  south  of  Europe.  It  is 
related  by  Abulfeda  that,  in  the  battle  of  Ohod,  where 
Mohammedanism  came  very  near  to  a  sudden  end  by 
the  crushing  defeat  of  the  prophet  and  his  followers, 
Haraza,  the  uncle  of  the  prophet,  seeing  in  the  op- 
posing ranks  a  Koreish  chief,  whom  he  knew,  thus 
called  out:  "Come  on,  3'ou  son  of  a  she-circumciser  1" 


Spread  of  Circumcision.  37 

As  Hfimza  was  among  the  slain,  it  is  most  likely  that 
he  met  his  death  from  the  hands  of  the  chief,  whose 
mother  really  followed  that  occupation.  So  extensive 
is  the  practice,  that  these  old  women  sometimes  go 
through  a  village  crying  out  their  occupation,  like 
itinerant  tinkers  or  scissors-grinders. 

The  present  ceremonies  attending  the  performance 
of  the  rite  among  the  Arabians  are  well  described  by  Dr. 
Delange,  a  surgeon  of  the  French  arm}',  as  witnessed  by 
him  in  the  province  of  Constantine,  in  Algeria. 

With  these  Arabs,  circumcision  is  performed  on  a 
whole  class,  so  to  speak,  at  the  same  time,  regardless  of 
the  trifling  differences  in  their  ages.  It  is  preceded  by 
feasting,  the  total  length  of  the  feast  being  for  eight  days. 
For  tlie  first  seven  da^'s,  all  the  Arabs  of  the  quarter 
where  the  candidates  for  circumcision  reside  dress  in 
their  best.  The  poor  have  their  mantles  and  clothes 
carefully  washed,  and  the  rich  deck  themselves  out  in 
tlieir  gold  and  silver  brocaded  vests  and  pantaloons. 
During  these  seven  da3's  there  is  general  rejoicing,  and 
the  Arabs  spend  most  of  this  time  in  the  village  street, 
racing^,  firino;  guns,  or  engaging  in  sham  battles  between 
the  different  camps,  during  which  one  carries  the  green, 
or  sacred  banner,  which  is  supposed  to  render  the  bearer 
invulnerable.  The  battle  ends  by  the  standard-bearer 
being  fired  at  by  all  parties,  and  falling,  but  quickly 
rising  again  and  waving  the  flag  in  token  of  its  protect- 
ing power.  The  Arabs  now  adjourn  to  another  public 
place,  where  the  notables  and  strangers  are  furnished 
seats  on  carpets  ;  here  a  dance  to  the  music  of  tumtums 
and  the  singing  of  invisible  females  takes  i)lace,  the 
dancers  being  only  males.^^  In  the  evening  the  women 
sing,  to  which  the  men  listen  in  silence,  this  concert 
being  kept  up  until  midnight.     On  the  seventh  da}^  the 


38  History  of  Circumcision. 

women,  decked  out  in  their  best,  and  with  all  their  per- 
sonal ornaments,  accompanied  by  all  the  3'oung  men, 
armed  with  their  guns  and  pistols,  repair  to  the  extremity 
of  the  oasis,  where  they  gather  plates  of  fine  sand. 
With  this  sand  tiiey  return  to  the  village,  where  it  is 
exposed  OA^ernight  to  the  glare  of  the  full  moon  on  the 
terraces  of  the  house.  This  last  day  closes  with  a  grand 
banquet,  given  by  the  rich  whose  children  are  about  to 
be  circumcised,  to  which  all  the  people  are  invited. 

The  next  moi'ning  all  the  relatives  of  the  candidates 
repair  to  the  house  where  the  rite  is  to  be  performed; 
the  women  going  up  into  the  second  floor,  wherefrom 
they  can  look  down  into  the  court  from  a  porcli  screened 
with  lattice-work,  without  themselves  being  seen.  The 
men  gather  together  on  the  ground-floor,  together  with 
the  operator  and  his  assistants  and  the  children  about 
to  be  circumcised,  who  are  dressed  in  3'ellow,  silken 
gowns.  The  child  to  be  operated  upon  is  seated  in  a 
pan  of  sand,  while  an  assistant  fixes  liis  arms  and  holds 
the  tliighs  well  separated  from  behind.  The  circumciser 
then  examines  the  pi'epuce,  the  glans,  and  removes  any 
sebaceous  collection.  This  done,  a  compress  with  an 
aperture  to  admit  of  the  passage  of  the  glans  is  slipi)ed 
over  the  organ  ;  a  small  piece  of  leather,  some  six  centi- 
metres in  diameter,  with  a  small  hole  in  the  centre,  is 
now  used,  the  free  end  of  the  prepuce  being  drawn 
through  the  aperture ;  a  ligature  of  woolen  cord  is  then 
tied  on  to  the  prepuce  next  to  the  front  of  the  leather 
shield,  and,  the  knife  being  applied  between  the  thread 
and  the  leather,  the  prepuce  is  removed  at  one  sweep  ; 
the  mucous  inner  layer  is  then  lacerated  with  the 
thumb-nails  and  turned  back  over  to  join  the  other 
parts.  The  surface  is  then  sprinkled  with  arar  or 
genevriere  powder  nnd  dressed  with  a  small  cloth  band- 


Spread  of  Circumcision.  39 

age,  the  subsequent  dressings  consisting  of  arar  powder 
and  oil.  During  the  operation  the  women  in  the  gallery 
keep  up  A,\\  unearthly  music  by  means  of  tumtums,  cym- 
bals, and  ail  the  kettles  and  saucepans  of  the  neighbor- 
hood, which  are  brought  into  requisition  for  the  occasion. 
This  music  is  accompanied  with  songs  and  chants,  each 
woman  striking  out  with  an  independent  song  of  her 
own,  either  improvised  or  suggested  by  the  occasion. 
This  not  only  serves  to  drown  the  cries  of  the  children, 
but  it  must,  in  a  manner,  assist  to  draw  them  away  from 
the  immediate  contemplation  of  their  sufferings.  The 
prepuces  arenow  gathered  together  and  carried  to  the  end 
of  the  oasis,  where  they  are  buried  with  ceremony  and 
rejoicings.  This  circumcision  only  takes  place  once  in 
three  or  four  years,  and  the  children  are  from  four  to  eight 
5'ears  of  age  ;  of  fifteen  circumcised  at  the  feast  witnessed 
by  M.  Delange,  only  two  had  passed  their  eighth  j^ear. 

In  a  very  interesting  old  book,^"*  "  The  Treaties  of 
Alberti  Bobovii,"  who  was  attached  to  the  court  of 
Mohammed  IV,  published  with  annotations  by  Thomas 
Hyde,  of  Oxford,  in  1690,  there  is  a  description  of  the 
Turkish  performance  of  the  rite  which  leads  one  to  infer 
that  they  circumcised  the  children  quite  3'ouug:  "  Et 
cum  puer  prae  dolore  exclamat,  imus  ex  duobus  parenti- 
bus  digitis  in  melle  ad  hoc  comparato  os  ei  obstruit ; 
cseteris  spectatoribus  acclamantibus.  0  Deus,  0  Deus, 
0  Deus,  Interim  quoque  Musica  perstrepit,  tympana 
et  alia  crepitacula  concutiuntur,  ne  pueri  planctus  et 
ploratus  audiatur."  Bobovii  says  that  the  age  at  which 
circumcision  is   performed  is  immaterial  provided  the 

candidate  is  old  enough  to  make  a  profession  of  faith, 

which,  however,  is  made  for  him  b}'  the  godfather, — in 
the  following  words  :  "  There  is  no  God  but  God.  and 
Mohammed   is   his   Prophet,"  or,  as   rendered   by  our 


40  History  of  Circumcision. 

autlioi",  "  Noil  esse  Deuiii  nisi  ipsum  Deum,  et  Moham- 
medeui  esse  Legatum  Dei."  To  wliicli  he  adds  that  the 
child  must  not  be  an  infant,  but  that  he  must  be  at 
least  eight  years  of  age.  Like  to  the  Arabs,  the  Turks 
celebrated  the  occasion  by  feasts,  plan's,  and  a  general 
good  time  ;  the  child  was  kept  in  bed  for  fifteen  days  to 
allow  complete  cicatrization  to  take  place.  The  circum- 
cision was  performed  with  the  boy  standing. 

Michel  Le  Feber,  writing  in  1681,^^  speaks  of  the 
tax  levied  on  the  Christians  by  the  Turks,  that  the^', 
the  Christians,  may  enjoy  liberty  of  conscience,  and  ob- 
serves that,  circumcision  not  being  compulsory  among 
the  Turks,  it  aften  led  to  trouble  and  anno3'ances,  as 
man}^  of  the  Turks  evaded  the  operation.  The  tax- 
gatherers  in  Turkey  are  very  industrious,  and,  as  being 
circumcised  was,  as  a  rule,  sufficient  evidence  of  not 
being  a  Christian,  he  often  witnessed  on  the  streets 
scenes  wherein  strangers,  arrested  b}'  these  tax-collectors, 
were  compelled  to  show  their  circumcision  as  an  indis- 
putable sign  of  their  exemption  from  the  tax.  He  also 
relates  that  in  their  zeal  for 'converts  to  Mohammedanism 
the  Turks  often  resorted  to  presents  to  induce  Christians 
to  embrace  their  faith.  While  in  Aleppo,  he  saw  a 
Portugese  sailor,  who,  through  presents,  had  forsaken 
his  religion,  but  who  had  repented  in  the  most  emphatic 
manner  when  brought  to  face  circumcision.  Finding 
entreaties  in  vain,  the  Cadi  ordered  the  immediate  ad- 
ministration of  a  stupefj'ing  draught,  and  the  sailor  was 
then  seized  and  circumcised  without  further  ceremony. 

In  cases  where  the  new  Mohammedan  is  reasonable 
and  submits  like  a  hero,  the  ceremonies  are  more  elabo- 
rate. Le  Feber  relates  that  if  the  candidate  is  a  man  of 
note  or  wealth  he  is  mounted  on  a  horse  and  exhibited 
all  over  the  city ;  he  is  dressed  in  the  richest  of  Turkish 


Spread  of  Circumcision.  41 

robes  and  in  his  hand  he  holds  an  arrow  with  the  point 
directed  to  the  sky  ;  he  is  followed  hy  a  great  concourse 
of  people,  some  dressed  in  holiday  attire  and  others  in 
fantastic  costumes;  and  general  feasting  and  enjoyment 
is  the  rule  over  the  course  of  the  march,  where  all  the 
people  run  to  swell  the  crowd.  If  the  man  happens  to 
he  a  poor  man,  he  is  simpl}'  hurriedly  marched  about  on 
foot,  with  a  simple  arrow  in  his  hand  pointed  skyward, 
to  distinguish  him  from  ordinary  mortals ;  before  him  a 
crier  proclaims  in  a  loud  voice  that  the  new  religionist  has 
ennobled  himself  by  professing  the  faith  of  the  prophet  in 
this  solemn  manner.  A  collection  for  his  benefit  is  taken 
up  among  the  booths  and  shops,  which  is  mostly  appro- 
priated by  the  conductor,  circumciser,  and  his  assistants, 
after  which  he  is  cii'cumcised  without  further  ado. 

The  same  author  describes  the  operation  as  per- 
formed on  the  3"onng  Turks  and  the  accompanying  cere- 
monies. They  differ  in  some  respects  from  those 
emplo^^ed  in  circumcising  a  convert.  The  parents  of 
the  child  give  a  feast  in  proportion  to  their  means,  to 
whicli  are  invited  the  relatives  of  the  family  and  personal 
friends  ;  if  of  the  upper  ranks,  he  is  promenaded  about  the 
town  to  the  mnsic  of  drums  and  cj'mbals,  dressed  in  rich 
attire ;  two  warriors  lead  the  procession  with  drawn 
swords,  and  a  troop  of  females  who  sing  songs  of  joy 
bring  up  the  rear;  the  procession  now  and  then  stops, 
when  the  two  gladiators  in  the  front  indulge  in  a  fierce 
set-to,  hacking  at  each  other  in  the  most  determined  and 
murderous  manner,  but  so  studiedlj-  shammy  tiiat  neither 
is  injured  ;  on  the  return  to  the  house,  the  child,  who  is 
•usually  eight  or  ten  j'ears  of  age,  is  bound  hand  and  foot 
to  prevent  his  causing  any  injur\-  to  himself,  laid  on  a 
bed,  and  circumcised  with  a  razor,  the  operation  being 
performed  either  by  a  surgeon  or  the  chief  of  a  mosque. 


CHAPTER  lY. 

Circumcision  Among  Savage  Tribes. 

E.  Casalis,^^  who,  in  the  capacity  of  missionary,  for 
a  veiy  long  time  resided  among  the  Bassoutos,  tells  us 
that  among  that  nation  the  operation  is  performed  at 
tlie  age  of  from  thirteen  to  fifteen  j^ears.  The  ceremony 
is  gone  through  once  in  three  or  four  years.  So  im- 
portant an  event  is  it  considered  by  the  Bassoutos  that 
the^'^  date  events  from  one  of  these  observances,  as  the 
Romans  dated  events  from  a  certain  consulship,  or  the 
Gi'eeks  from  an  Olympiade.  At  the  time  fixed,  all  the 
candidates  go  through  a  sham  rebellion  and  escape  to 
the  woods;  the  warriors  arm  and  give  chase,  and,  after 
a  sliam  battle,  capture  the  insurgents,  whom  the}-  bring 
back  as  prisoners,  amidst  dancing  and  great  rejoicings, 
which  are  the  preludes  to  the  feast.  The  next  day  the 
huts  of  mystery  {mapato)  are  erected,  where,  after  the 
circumcision,  the  young  men  are  to  reside  for  some  eight 
months,  under  the  tutorship  of  experienced  teachers, 
who  drill  them  in  the  use  of  the  spear,  sword,  and  shield, 
teaching  them  to  endure  hunger,  thirst,  blows,  and  all 
manner  of  hardships  ;  prolonged  fasts  and  cruel  flagella- 
tions being  regarded  as  pastimes  between  the  exercises. 
The  severit}^  of  the  regulations  ma^^  be  judged  from  the 
fact  that  the  instructors  have  a  right  to  put  to  death  any 
one  who  may  try  to  escape  from  these  ordeals.  The 
women  are  rigorously  excluded  from  these  camps,  but 
the  men  are  allowed  to  visit  them,  when  the}^  have  the 
privilege  of  assisting  the  teachers  by  adding  additional 
blows  and  precepts  to  the  backs  of  the  unlucky  candi- 
^42) 


Circumcision  Among  Savage  Tribes.  43 

dates.  After  eight  months  of  such  training,  the  young 
men  are  oiled  from  head  to  foot  and  dressed  in  a  gar- 
ment, and  are  now  given  the  name  which  they  are  to 
bear  for  the  rest  of  their  lives.  The  mapato,  or  mystery 
hut,  is  now  burned  to  the  ground  and  the  young  men 
return  to  the  village.  The  maternal  uncle  of  the  3'outh 
here  presents  him  with  a  javelin  for  his  defense,  and  a 
cow  that  is  to  furnish  him  with  nourishment.  Until  the 
time  of  his  marriage,  tlie  newly  circumcised  dwell 
together ;  their  duties  being  of  a  menial  character,  such 
as  gathering  wood  and  attending  to  the  flocks  and  droves. 

M.  Paul  Lafargue  looks  upon  circumcision  among 
the  negro  races  as  being  a  rite  commemorating  their 
advent  to  manhood  ;  Livingstone,  who  has  also  observed 
the  above,  related  incidents  in  relation  to  the  perform- 
ance of  boguera,  or  circumcision,  among  the  Bassoutos, 
believes  tliat  with  them  the  rite  has  a  purely  civil  sig- 
nificance, being  in  no  wa}'^  connected  with  religion. 

Among  many  of  the  African  tribes  the  j^oung  maids 
have  an  ordeal  approaching  to  circumcision  that  they 
must  pass  wlien  near  the  age  of  thirteen,  this  rite  bear- 
ing precisely  the  same  relation  regai'ding  their  entrance 
into  the  state  of  womanhood  that  male  circumcision 
denotes  the  entrance  into  manhood  on  the  part  of  the 
males  among  tlie  Bassoutos,  At  the  appointed  time  the 
maids  are  gathered  together  and  conducted  to  the  river- 
bank;  the}'  are  placed  under  the  care  of  expert  matrons. 
Tliey  here  reside,  after  having  undergone  a  kind  of  bap- 
tism ;  they  are  maltreated,  punished,  and  abused  by  the 
old  women,  with  a  view  of  making  them  hardy  and 
insensible  to  pain  ;  they  are  also  schooled  in  the  science 
and  art  of  African  household  duties.  Among  the  Gal- 
linas  of  Sierra  Leone,  in  addition  to  the  other  observ- 
ances, the  clitoris  of  the  3'oung  maid  is  excised  at  mid- 


44  History  of  Circumcision. 

night,  while  the  moon  is  at  its  full,  after  which  they 
receive  tlieir  name  by  which  they  are  to  be  known 
througli  life.  The  initiation  of  each  sex  into  these 
mysteries  is  exclusively  for  the  sex  engaged,  and  it 
would  be  as  fatal  for  a  man  to  steal  into  the  camp  of  the 
women  during  the  performance  of  these  ceremonies  as  it 
would  be  fatal  for  a  woman  to  enter  a  mapato  where  the 
young  men  are  undergoing  their  ordeal.  After  their 
initiation  into  womanhood,  tlie  maids  live  by  themselves, 
similarly  to  the  young  men,  until  they  marry. 

Lafargue  relates  that  among  the  Australians  circum- 
cision is  held  in  such  importance  that  tribes  at  war  will 
suspend  all  hostilities  and  meet  in  peace  during  the 
observance  or  performance  of  the  rite.  Here,  again, 
we  have  a  repetition,  with  a  slight  variation,  of  the  prac- 
tices of  the  Bassoutos, — something  which  gives  some 
countenance  to  the  hero-warrior  idea  of  the  origin  of 
circumcision  advanced  by  Bergmann.  The  Australian 
warriors  go  through  a  mimic  battle,  and,  after  a  series 
of  combats,  finally  capture  the  boys  aged  about  from 
thirteen  to  fourteen  3ears,  whom  they  bear  away  amidst 
tlie  cries  and  lamentations  of  the  mothers  and  other 
female  relatives,  who,  in  their  excess  of  grief,  mutilate 
themselves  by  cutting  gashes  into  their  thighs,  so  that 
they  bleed  profusely.  The  boys  are,  in  the  meantime, 
carried  to  some  out-of-the-way  place,  where  an  old  man, 
perched  on  a  tree  or  some  rising  ground,  through  the 
means  of  a  musical  instrument  made  of  a  deal-board 
and  human  hair,  announced  that  the  rite  is  in  process 
of  performance,  so  that  neither  women  nor  children 
might  approach.  Tufts  of  moss  are  placed  in  the 
axilla  and  on  the  pubis,  to  represent  puberty,  and  among 
some  tribes  the  skin  of  the  penis  is  divided  to  the 
scrotum  with  a  stone  knife,  while  others  content  them- 


Circumciaion  Among  Savage  Tribes.  45 

selves  with  simply  making  a  circular  incision,  which 
removes  the  prepuce,  after  the  Jewish  manner,  the  ex- 
cised portion  being  placed  as  a  ring  on  the  median 
finger  of  the  left  hand.  Tiie  circumcised  then  takes 
himself  to  the  hills  or  woods,  and  there  remains  until 
healed,  carefully  guarding  himself  against  the  approach 
of  any  female.  After  this  the  third  part  of  the  ceremo- 
nies takes  place:  the  godfather  of  the  3^outh  opens  a 
vein  in  his  own  arm,  the  circumcised  3'outh  is  placed  on 
all-fours,  and  an  incision  is  made  from  the  neck  down  as 
far  as  the  lumbar  region,  and  the  blood  of  the  god- 
father is  made  to  flow  and  mingle  with  that  of  tlie  god- 
child ;  this  being  in  realit3'  a  bloody  baptism,  and  a 
near  relation  to  the  l)lood-compacts  of  the  Arabs. 

The  Malays,  as  well  as  the  men  of  Borneo,  are 
circumcised.  The  Battos  likewise  perform  the  rite. 
Among  the  Islanders  they  sometimes  ligate  the  prepuce 
so  that  it  drops  ofl".  Among  the  Battos  the  same  object 
is  reached  by  small  bamboo  sticks,  between  which  the 
prepuce  is  fastened.  In  New  Caledonia  and  Tidshi  the 
boys  are  circumcised  in  their  seventh  3'ear.  Tlie  Tonga 
Islanders  split  the  prepuce  on  the  dorsum  with  a  piece 
of  bamboo  or  of  shell.  In  the  Marquesas  and  Sandwich 
Islands  the  operation  is  superintended  b3^  the  priests. ^'^ 


CHAPTER  Y. 

Infibulation,  Muzzling,  and  other  Curious 
Practices, 

It  seems  a  matter  of  controvers}^  as  to  whether  the 
Mexicans  did  or  did  not  circumcise  their  cliildren.  Tiiat 
they  had  a  blood-covenant  is  admitted  by  tlie  historians, 
as  well  as  the  fact  that  this  blood  was  taken  from  the 
prepuce ;  but  that  the  prepuce  was  actually  removed  is 
something  that  is  not  agreed  upon  by  all  authorities. 
Las  Casas  and  Mendieta  state  that  it  was  practiced  by 
the  Aztecs  and  Totonacs,  while  Brasseur  de  Bourbourg 
found  traces  of  its  practice  among  the  Mijes.  Las  Casas 
states  that  on  the  twenty-eighth  or  the  twenty-ninth  day 
the  child  was  presented  to  the  temple,  when  the  high- 
priest  and  his  assistants  placed  it  upon  a  stone  and  cut 
off  the  prei)uce,  the  excised  part  being  afterward  burnt 
in  the  ashes.  Girls  of  the  same  age  were  deflowered  by 
the  finger  of  the  high-priest,  who  ordered  the  operation 
to  be  repeated  at  the  sixth  3'ear;  and  once  a  year,  at  the 
fifth  month,  all  the  children  born  during  the  year  were 
scarified  on  the  breast,  stomach,  or  arms,  to  denote  their 
reception  as  servants  of  their  god.  Clavigero,  on  the 
other  hand,  denies  that  circumcision  was  ever  practiced. 
It  was  customary  in  Mexico,  according  to  most  authori- 
ties, to  take  the  children  while  infants  to  the  temple, 
where  the  priests  made  an  incision  in  the  ear  of  the 
females,  and  an  incision  in  the  ear  and  prepuce  of  the 
males.^* 

Grotius  and  Arias  Montan  at  one  time  advanced  the 
idea  that  the  western  coast  of  South  America  was 
(46) 


Tnjib Illation,  3Iuzzlwg,  and  other  Curious  Practices.     47 

peopled  by  some  mutinous  sailors  from  the  fleets  of 
King  Solomon,  who,  in  their  endeavor  to  go  away  far 
enough  to  be  out  of  reach,  were  driven  by  winds  and 
chance  to  the  Peruvian  coast.  Others  have  imagined 
that  some  of  tlie  lost  tribes  of  Israel  found  their  way 
eastward  to  America,  by  the  way  of  China,  to  the 
Mexican  coast.  The  same  ideal  tradition  has  made  the 
lost  tribes  the  fathers  of  the  Iroquois  Nation  in  the 
northeastern  parts  of  the  United  States.  An  author, 
who  will  be  quoted  in  another  part  of  this  work,  scouts 
the  idea  that  the  rite,  as  performed  in  America,  had  any 
connection  or  common  origin  with  the  rite  performed 
in  Asia  and  Africa;  but,  true  to  his  theory  of  the  climatic 
causes  of  the  origin  of  circumcision,  he  maintains  that 
it  originated  here  as  it  did  elsewhere,  being  a  perform- 
ance born  of  climatic  necessity.  He  is,  however,  dis- 
satisfied with  Father  Acosta  fur  not  being  more  explicit 
in  relation  to  the  modus  operandi  of  the  Mexican  cir- 
cumcision. The  w^ant  of  being  explicit,  and  its  conse- 
quences in  this  particular  regard,  may  be  inferred  from 
a  "  Diatribe  on  Circumcision,"  by  a  Mr.  Mallet,  in  an 
encj'Clopaedic  dictionary  of  the  last  century,  in  which 
Mr.  Mallet  informs  his  readers  that  the  Mexicans  were 
in  the  habit  of  cutting  off  the  ears  and  prepuces  of  the 
newl}^  born.  Herrera  and  Acosta  agree  with  Clavigero 
in  asserting  that  the  Mexicans  simply  hied  the  prepuce. 
Pierre  d'Angleria  and  other  contemporar}^  writers  are 
as  emphatic  in  asserting  that  in  the  island  of  Cosumel, 
in  Yucatan,  on  the  sea-board  of  the  Gulf  of  Mexico 
and  on  the  Florida  coast,  they  have  observed  circum- 
cision b}^  the  complete  removal  of  the  prepuce  with  a 
stone  knife.  The  Spanish  monk,  Gumilla,  relates  that 
the  Saliva  Indians  of  the  Orinoco  circumcised  their 
infants  on  the  eighth  day.     These  Indians  also  included 


48  History  of  Circumcision. 

the  fenifiles  in  the  observance  of  the  rite.  The  same 
author  tells  us  of  the  barbarous  and  bloody  perform- 
ances, in  relation  to  the  rite,  of  the  nations  on  the 
banks  of  the  Quilato  and  the  Uru,  as  well  as  those 
dwelling  along  the  streams  that  empty  into  the  Apure. 
The  same  is  said  of  the  Guamo  and  of  the  Othomacos 
Indians  ;  according  to  Gumilla,  many  of  these  Indians, 
in  addition  to  the  rite  of  circumcision,  inflicted  a  num- 
ber of  cuts  on  the  arms,  legs,  and  OA'er  the  body,  to  a 
degree  that  amounted  to  butcher}',  the  child  being 
reserved  for  this  inhuman  treatment  until  the  age  often 
or  twelve  years,  that  he  might,  by  iiis  greater  powers  of 
resistance  and  of  recuperation,  stand  some  chance  of 
escaping  alive  from  the  ordeal,  Tiie  friar  mentions  that 
in  1721  he  fonnd  a  child  dying  from  this  treatment,  the 
wounds  having  become  gangrenous  and  the  chikl  dying 
of  pyaemia  ;  prior  to  the  operation  the  children  were 
stupefied  with  some  narcotic  drink,  and  were  insensible 
during  its  performance.^^ 

Besides  circumcision,  the  Americans  practiced  sev- 
eral other  operations  that  bore  an  analog^'^  to  tlie  opera- 
tion of  infibulation,  a  procedure  common  to  the  Orient 
and  to  early  Europe,  and  so  ancient  that,  like  circum- 
cision, its  source  is  in  the  misty  clouds  of  antiquity-. 
It  consisted  in  introducing  a  large  ring,  either  of 
gold,  silver,  or  iron,  tlirough  an  opening  made  into 
the  prepuce,  the  free  ends  being  then  welded  together. 
Females  were  treated  likewise,  the  ring  including  both 
labia.  In  some  countries  an  agglutination  of  the  parts 
induced  by  some  irritant  or  a  cutting  instrument  an- 
swered the  purpose  aniong  females.  Dunglison  mentions 
that  the  prepuce  was  first  drawn  over  the  glans,  and 
then  that  the  ring  transfixed  the  prepuce  in  that  posi- 
tion ;    that  the  ancients  so   muzzled  the  gladiators  to 


Infihulation,  Muzzling^  and  other  Curious  Practices.     49 

prevent  them  from  being  enervated  by  venereal  indul- 
gence. Tlie  ancient  Germans  lived  a  life  of  chastity 
wntil  their  marriage,  and  to  their  observance  of  a  chaste 
life  can  be  attributed  the  superior  pln'sical  development 
of  the  race,  as  both  males  and  females  were  not  only 
fully  developed,  but  were  not  enervated  by  either 
sexual  excess  or  inclinations  before  having  offspring, 
which  were  necessarily  robust  and  health}'.  To  obtain 
the  same  results  in  a  nation  given  to  indolence  and 
luxury,  and  lax  in  its  moralit}^,  some  physical  restraint 
was  required,  and  we  therefore  find  the  practice  of  infibu- 
lation  coming  from  the  warm  countries  to  the  East.  The 
ancients  not  only  infibulated  their  gladiators  to  restrain 
them  from  venery,  but  they  also  subjected  their  chanters 
and  singers  to  the  same  ordeal,  as  it  was  found  to  improve 
the  voice  ;  comedians  and  public  dancers  were  also  re- 
strained from  ruining  their  talents  b}^  the  means  of 
infibulation.  In  an  old  Amsterdam  edition  of  Locke's 
"  Essa}^  on  the  Extent  of  the  Human  Understanding," 
there  is  a  quotation  from  the  voyages  of  Baumgarten, 
wherein  he  states  having  seen  in  Egypt  a  dcA'out  der- 
vish seated  in  a  perfect  state  of  nature  among  the  sand- 
hillocks,  who  was  regarded  as  a  most  holy  and  chaste 
man  for  the  reason  that  he  did  not  associate  with  his 
own  kind,  but  only  with  the  animals.  As  this  was  by 
no  means  an  uncommon  case,  it  led  the  Greek  monks, 
in  Greece  and  Asia  Minor,  to  resort  to  everj-  expedient 
to  protect  their  chastity ;  in  some  of  the  monasteries 
not  only  were  the  monks  muzzled  by  the  process  of 
infibulation,  but  they  even  had  rules  that  excluded  all 
females,  either  human  or  animal,  from  within  their  con- 
vent,— a  habit  that  still  prevails  among  man}'  of  the  con- 
vents of  the  Orient  to  this  day, — that  on  Mount  Athos 
especially,  omitting  the  infibulation  of  the  ancients. 


50  History  of  Girmimcision. 

Readers  living  in  the  climates  of  extreme  ranges 
and  of  seasonal  change  cannot  understand  the  physical 
temptations  that  beset  mortals  in  certain  climates,  any 
more  than  they  can  imagine  the  faultless  condition  of 
the  climate  itself.  The  subject  of  climatic  influences 
will  be  more  full}-  discussed  further  on  ;  but  climate,  as 
a  factor  of  habits  and  usages  in  one  part  of  the  world, 
that  are  incomprehensible  to  those  living  in  others, 
plays  a  part  that  is  but  little  appreciated  or  understood  ; 
whether  it  be  the  question  of  diet,  dress,  or  custom, 
climate  exerts  its  influence  in  no  uncertain  manner.  As- 
Sulpicius  Severus  remarked  to  the  Greek  monks,  when 
the^'  accused  the  Gaulish  monks  with  voracit}^  and  glut- 
tony, "  That  which  you  of  Greece  consider  as  superfluous, 
the  climate  of  Gaul  renders  into  a  positive  necessit\'."' 
So  of  all  physical  needs  and  passions, — they  are  subject 
to  a  similar  law.  Those  who  have  read  Canon  Kings- 
le^^'s  small  work  on  the  "  Hermits  of  Asia,  Africa,  and 
Europe"  will  appreciate  the  above  remarks  ;  and  it  may 
be  incidentally  mentioned  that  his  description  of  the 
climate  that  is  common  to  the  hilly  country'  bordering  on 
the  eastern  half  of  the  Mediterranean  Sea  gives  as  vivid 
and  as  graphic  a  description  of  the  physical  condition 
of  the  climate  and  of  its  effects  as  can  well  be  written. 
It  occurs  in  the  life  of  the  hermit  Hilarion,  and  the  de- 
scription given  relates  to  his  last  home  in  the  ruins  of 
an  old  temple,  situated  on  a  cliff  in  the  island  of  Cy- 
prus, where  the  air  is  so  invigorating  that  "  man  needs 
there  hardly  to  eat,  drink,  or  sleep,  for  the  act  of  breath- 
ing will  give  life  enough."  The  work  gives  the  best 
insight  also  into  origin  and  causes  that  led  to  mona- 
chism,  as  well  as  it  tells  the  benefit  tliat  the  condition 
conferred  on  humanit}',  showing  a  phase  in  the  march 
of  civilization  that  is  but  little  understood. 


Injibulation,  Muzzling,  and  othe?-  Curious  Practices.     51 

But,  to  return  to  the  subject  of  infibnlation,  wliicb 
has,  in  a  manner,  necessitated  this  digression  from  the 
main  topic.  Thwing^"  informs  ns  that  in  ancient  Ger- 
many woman  was  considered  the  moial  equal  of  man, 
and  that  woman  might  traverse  the  vast  stretches  of 
country  unprotected  and  unharmed.  Woman  never 
held  such  a  position  in  the  Oriental  countries  ;  neither 
has  man,  under  the  sub-tropics,  a  like  self-conmiand  as 
shown  b}^  those  ancient  Gaids.  So  that,  with  the  advent 
of  Christianity'  and  the  moral  revolution  tliat  followed, 
primitive  metliods,  either  inflicted  on  others  or  self- 
inflicted,  were  adoi)ted  to  insure  a  chaste  life.  Infibnla- 
tion was  known,  as  already  stated,  for  centuries,  and  in 
those  rude  times  it  seemed  as  the  most  natural  and  ■ 
effective  mode  of  accomplishing  the  object.  It  was  not 
s  barbarous  an  operation  as  emasculation  on  the  male, 
.IS  it  onl3'  temporarily  interfered  with  his  functions. 

In  the  Old  World  the  practice  is  still  performed  in 
various  manners.  In  Ethiopia,  when  a  female  child  is 
born  the  vulva  is  stitched  together,  allowing  only  the 
necessary  passage  for  the  needs  of  nature.  These  parts 
adhere  together,  and  the  father  is  then  possessed  of  a 
virgin  which  he  can  sell  to  the  highest  bidder,  the  union 
being  severed  with  a  sharp  knife  j ust  before  marriage.  In 
some  parts  of  Africa  and  Asia,  a  ring,  as  before  stated, 
transfixed  the  labia,  which,  to  be  removed,  required 
either  a  file  or  a  chisel ;  this  is  worn  only  bj'-  virg-ins. 
Married  women  wear  a  sort  of  muzzle  fastened  around 
the  body,  locked  by  means  of  a  key  or  a  padlock,  the 
key  being  onl}^  in  the  possession  of  the  husband.  Thp 
wealthy  have  their  seraglios  and  eunuchs,  that  take  the 
place  of  the  belt  and  lock.  Another  method  is  a  mailed 
belt  worn  about  the  hips,  made  of  brass  wire,  with  a 
secret   combination  of  fastenings,  known    only  to  the 


52  History  of  Circuvicision. 

husband.  In  the  museum  in  Naples  are  to  be  seen  some 
of  these  belts,  studded  with  sharp-pointed  pikes  over 
the  abdominal  part  of  tlie  instrument,  which  was  calcu- 
hited  to  prevent  even  innocent  familiarity,  such  as  nest- 
hiding,  to  say  nothing  of  greater  evils. 

In  the  ■"  Les  Femmes,  Les  Eunuchs,  et  Les  Guer- 
rieres  du  Soudan,"  Col.  Du  Bisson  mentions  a  very 
peculiar  custom  invented  by  the  careful  jealousy  tliat 
is  inseparable  from  harem  life.  He  had  noticed  that 
man}-  of  the  harem  inmates,  contrary  to  the  general  Ori- 
ental custom,  were  allowed  to  go  about  unattended  by  the 
usual  guard  of  eunuchs,  but  that  they  walketl  in  a  pain- 
ful, hesitating,  and  impeded  manner.  This  walk  was 
jiot  the  conventional,  short,  shuffling  step  that  pecu- 
liarity^ of  dress  and  shoe-wear  imposes  on  the  Jn  panese 
beauty,  nor  the  willowy,  swa3'ing  gait  produccrl  in  the 
Chinese  beauty  by  the  lack  of  a  sufficiency  ot  foot ; 
neither  could  it  be  ascribed  to  the  presence  of  the  an- 
cient jingling  chain  of  bells  which  induced  the  mincing 
steps  of  the  virgins  of  Judea, — an  invention  which  con- 
fined the  lower  limbs  within  certain  limits  b}^  being  worn 
just  below  the  knees,  and  calculated  to  prevent  the  rup- 
ture of  the  hymen  by  any  undue  length  of  step  or  vio- 
lent exercise  ;  hence  a  tinkling  noise  and  a  mincing  step 
alwaj'S  denoted  a  virgin.  In  Du  Bisson's  cases,  how- 
ever, virgins  were  out  of  the  question  ;  they  might  be 
the  victims  of  enforced  continence,  but  a  Soudanese 
harem  contains  no  virgins.  On  inquiry  he  learned  that 
the  very  peculiar  and  unmistakably  painful  gait  was 
due  to  the  fact  that  each  woman  carried  a  bamboo  stick, 
about  eight  inches  in  length,  three  inches  or  more  being 
inserted  in  the  vagina  so  as  to  effectually  fill  the  opening, 
the  balance  projecting  beyond,  between  the  thighs  of  the 
person  ;  tnis  bamboo  stick,  or  guardian  of  female  virtue, 


Injibulation,  Muzzling,  and  other  Curious  Practices.     53 

was  held  in  place  by  a  strap  with  a  shield  that  covered 
the  vulva,  the  whole  apparatus  being  strapped  about  the 
hips  and  waist,  and  the  whole  being  held  in  an  undis- 
pkceable  position  by  a  padlock.  This  was  affixed  to  the 
woman  whenever  she  was  allowed  outside  the  harem 
grounds,  being  placed  in  position  by  the  eunuch,  who 
carried  the  key  at  his  girdle.  In  such  a  harness  virtue 
can  be  considered  perfectly  safe ;  even  safe  from  any 
mental  depredation  or  revolution,  as,  with  the  plug 
causing  such  uncomfortable  sensations,  it  is  perfectly 
safe  to  infer  that  the  imagination  could  not  be  seduced 
by  an}'  Don  Juanic  or  other  B3'ronic  unvirtuous  revelry. 
Tlie  pliysical  ills  that  this  contrivance  must  cause  are 
necessarily  without  number,  as  the  instrument  is  not  as 
liglitlj'  constructed  as  our  modern  stem  pessaries  ;  but  to 
the  Oriental  who  can  replace  a  woman  at  any  time  and 
who  prizes  the  virginitj',  continence,  and  chastity  of  his 
slaves,  even  if  enforced,  more  than  their  health  or  their 
lives,  these  are  matters  of  secondary  importance.  In 
the  Soudan  there  are  no  divorce  courts,  hence  the  prob- 
able necessity  of  the  apparatus,  and,  as  the  woman  is 
not  obliged  to  wear  it  unless  she  chooses  to  go  out  un- 
attended, it  can  hardly  be  considered  as  a  compulsory 
barbarity.  In  the  United  States  such  a  practice  might 
do  away  with  considerable  divorce  proceedings. 

Celsus  gives  a  detailed  description  of  the  manner  of 
infibulating  as  practiced  among  the  Romans.  Accord- 
ing to  this  autliority,  it  was  employed  by  them  on  the 
youth  attending  the  public  schools,  as  well  as  upon  the 
actors,  dancers,  and  choristers,  who  were  sold  to  the 
directors  of  the  plays  and  s[)ectacles.  In  the  cabinet  of 
the  Roman  College  there  ai-e  to  be  seen  two  small  statues 
representing  two  inflbulated  musicians,  which  are  re- 
markable for  the  excessive  size  of  the  ring  and  the  lean- 


54  History  of  Circumcision. 

ness  of  the  persons  to  wliicli  they  are  attached.  The 
mode  of  applying  this  ring  did  not  differ  much  from 
the  usual  method  of  preparing  the  ear  for  pendants.^^ 

Among  the  Greek  monks  mentioned,  the  infibulation 
serves  a  manifold  purpose  ;  it  not  only  is  a  sure  badge 
of  chastity,  but  its  weight  and  size  is  very  often  in- 
creased so  as  to  render  it  an  instrument  of  penitence, 
and  considerable  riA^alry  exists  at  times  in  this  regard. 
Virey  notices  that  the  Hindoo  bonze,  or  fakir,  at  times 
submits  to  infibulation  at  the  same  time  that  he  takes 
his  vows  of  eternal  chastity.  This  ring  is  at  times 
enormous,  being  sometimes  six  inches  in  diameter ;  so 
that  it  is  a  l)urden.  These  saints  are  held  in  great 
esteem  and  veneration. 

Nelaton,  in  the  sixth  volume  of  his  "  Surgery," 
mentions  the  case  of  a  man  who  presented  himself  at 
Dupuytren's  clinic  with  a  tumefied,  thickened,  and  some- 
what dilapidajted  and  ulcerated  prepuce ;  this  prepuce 
had  worn  a  couple  of  golden  padlocks  for  five  j^ears, 
a  woman  havino-  thus  infibulated  his  oroan. 

In  an  elaborate  work  on  the  subject  of  circum- 
cision ,^2  de  Vanier  du  Havre  relates,  on  the  authority 
of  M.  Martin  Flaccourt,  that  with  the  Madecasses  the 
children  are  circumcised  on  the  eighth  day  after  birth; 
and  that  in  some  portions  of  the  country  the  mother 
swallows  the  removed  portion  of  the  prepuce,  while  in 
others  the  father  loads  the  prepuce  in  some  form  of  fire- 
arm, which  is  afterwai'd  fired  in  the  air.  In  the  neigh- 
borhood of  Djezan,  in  Arabia,  as  reported  by  M.  Ful- 
gence  Fresnel  in  the  Revue  de  Deux  Mondes  of  1838, 
courtship  and  matrimony  are  not  so  great  social  events 
as  they  are  with  our  society  beaux.  The  occasion  is 
probabl}^  considered  social  enough  by  the  rest  of  the 
invited  guests,  but  it  can  hardly  be  called  an  agreeable 


Infihidation^  Muzzling^  and  other  Curious  Practices.     55 

episode  in  tlie  life  of  tlie  groom.  Tliose  wliose  bashful- 
uess  prevents  them  from  contracting  marriage  in  civil- 
ized communities  can  have  the  consolation  of  knowing 
that  in  far-ojff  Arabia,  among  the  fierce  followers  of  the 
conquerors  of  Spain  and  of  the  Eastern  Empire,  they 
have  sympathizing  fellow-sufferers  whom  the  conven- 
tionalities of  the  country  deter  from  rushing  into  matri- 
mony. In  this  region,  circumcision  is  performed  on  the 
adult  at  the  time  of  his  candidacy  for  matrimonial  bliss. 
A  more  inauspicious  occasion  could  not  possiblj'  have 
been  chosen,  unless  as  in  another  Mohammedan  tribe,  who 
circumcise  the  bridegroom  on  the  day  after  his  marriage 
and  sprinkle  the  blood  that  falls  from  the  cut  onto  the 
veil  of  the  bride.  The  bride  is  present,  and  the  victim 
is  handed  over  to  what  might  be  called  the  executioner 
of  the  holy  office,  who  proceeds  to  circumcise  the  victim 
in  what  might  be  called  its  utmost  degree  of  perform- 
ance and  barbarit}'.  This  attention  does  not  stop  at  the 
pendulous  and  loose  prepuce.  He  devotes  himself  to 
the  skin  of  the  whole  organ  ;  beginning  at  the  prepuce 
he  gradually  works  backward,  removing  the  whole  skin 
of  the  penis — a  flaying  alive,  and  nothing  more.  Should 
the  victim  betra3^  any  sign  of  weakness,  or  allow  as 
much  as  a  sigh  or  groan  to  escape  him,  or  even  allow  the 
muscles  of  the  face  to  betray  the  fact  that  he  is  not 
immensely  enjoying  the  occasion,  the  bride  elect  at  once 
leaves  him  for  good,  saj-ing  that  she  does  not  wish  a- 
woman  for  a  husband.  A  large  proportion  of  the  male 
population  annually  die  from  this  operation.  So  that 
the  Arabs  of  the  Djezin  can  be  likened  to  those  spiders 
who  lose  their  life  while  in  the  act  of  copulation, — the 
female  making  a  dinner  from  off  the  male, — onl}'  the 
spider  is  said  to  die  a  happy  death,  while  that  of  the 
Arab  is  one  of  misery. 


56  History  of  Circumcision. 

Margrave  and  Martyr  have  recorded  a  very  peculiar 
practice  common  among  some  Soutli  American  tribes : 
A  kind  of  a  tube  is  fastened  onto  tiie  prepuce  by  means 
of  threads  of  ttie  tacoynhaa,  the  latter  being  the  bark  of 
a  certain  kind  of  a  tree.  Cabras  brought  one  of  the 
natives,  so  muzzled,  to  Lisbon,  on  the  return  from  his 
first  voyage.  Some  tribes  were  observed  to  wear  an 
apparatus  like  the  old-fashioned  candle-extinguisher,  the 
virile  member  having  been  forced  into  this  receptacle, 
which  was  strapped  about  the  loins. 

The  travelers  Spix  and  Martius  found  the  practice 
of  circumcision  of  both  sexes  in  the  region  of  the  upper 
Amazon  River  and  among  the  Tuncas.  Squires  men- 
tions a  curious  custom  of  the  aborigines  of  Nicaragua. 
The3'  wound  the  penis  of  their  little  sons  and  let  some 
of  the  blood  flow  on  an  ear  of  corn,  which  is  divided 
among  the  assembled  guests  and  eaten  by  them  with 
great  ceremony. 

On  the  fifth  day  after  birth  it  is  the  custom  among 
the  Omaha  Indians  of  North  America  to  christen  the 
infant,  the  child  being  stripped  and  spotted  with  a  red 
pigment;  considerable  ceremon}' accompanies  the  act.^' 

Among  the  cannibals  of  Australia,  Lumholtz^*  ob- 
served a  practice  that  seems  to  have  no  analogue  in  the 
wide  world,  either  as  an  operation  or  in  i-egard  to  itf 
purposes.  About  ninety-live  per  cent,  of  the  childre: 
are  subjected  to  the  ordeal.  This  is  no  less  than  the  fo/ 
mation  of  an  artificial  hypospadias ;  this  abnormality  is 
formed  through  the  penis  into  the  urethra,  near  its  junc- 
tion with  the  scrotum  ;  the  wound  is  about  an  inch  in 
length  and  is  made  with  a  flint  knife  which  serves  for  no 
other  purpose ;  the  edges  of  the  wound  are  burned  with 
a  hot  stone,  and  the  wound  is  subsequentl}-  kept  open 
b}-  the  introduction  of  a  small  piece  of  wood,  which,  on 


Tnfibulation,  Muzzling^  and  other  Curious  Practices.     57 

healing,  leaves  a  permanent  opening.  These  cannibals 
undoubtedly  are  inspired  by  some  Malthnsian  spirit 
which  impels  them  thus  to  functionally  eunuchize  them- 
selves in  one  sense,  as  during  copulation  the  seminal 
discharge  flies  out  backward  through  this  opening,  being 
thereby  a  most  efl'ectual  check  on  further  procreation. 
By  some,  this  practice  has  been  attributed  to  the  unrelia- 
bility of  the  seasons  in  regard  to  food-production  ;  but 
Lumholtz  observes  that  where  the  practice  is  most  in 
vogue — among  the  tribes  to  the  west  of  the  Diamantina 
River  and  west  and  north  of  the  Gulf  of  Carpentaria — 
the  food-supplj'  is  not  deficient,  the  region  being 
full  of  rats,  fish,  and  vegetables.  All  the  tribes  are  not 
subject  to  the  practice  of  the  operation  at  the  same  time 
of  life;  in  some,  the  h3'pos[)adias  is  not  produced  until 
in  adult  life  and  after  the  person  has  married  and  has 
become  the  father  of  one  or  two  children,  when  he  must 
submit  to  the  requirements  of  the  law;  the  operation 
seems  to  be  invested  with  some  civil  or  religious  signifi- 
cance, as  a  palisade  or  stockade  of  trees  is  placed 
around  the  place  where  it  is  performed.  A  native, 
aged  about  twenty  j-ears,  informed  Lumholtz  that 
the  operation  was  performed  because  the  blacks  did 
not  like  to  hear  the  children  cry  about  the  camp,  and, 
further,  that  they  were  not  desirous  of  having  many 
children  ;  this  native  had  not  yet  become  a  father  and 
had  not  j'et  been  subjected  to  the  operation.  The 
natives  T\ere  observed  to  be  fat  and  in  good  physical 
condition. 

Thei'e  is  something  mj'sterious  in  this  operation.  It 
can  easily  be  conceiA'ed  how^  circumcision  might  at 
limes  have  been  suggested  b}-  its  spontaneous  and 
natural  performance  without  any  assistance  from  man. 
Culleri'^r    reports    one    case    of    partial    circumcision 


58  History  of  Circumcision. 

througli  the  ineaus  of  an  accident  happening  to  a  painter. 
The  man  was  at  work  on  a  ladder,  with  a  small  bucket 
of  paint  hooked  into  one  of  tlie  rounds  above  him  ; 
through  some  means  the  bucket  lost  its  hold  and  in 
falling  struck  tlie  penis  on  its  dorsum  with  such  force 
that  the  prepuse  was  cut  througli  on  a  parallel  with  the 
corona  of  the  glans  for  fully  two-thirds  of  its  circumfer- 
ence, the  glans  slipping  through  the  opening  and  gather- 
ing in  a  fleshy  bunch  underneath  the  frenum.  This  man 
carried  this  abnormality  for  some  3"ears,  when,  desiring 
to  many  and  seeing  tiiat  this  appendage  would  be  as 
much  of  an  impediment  as  one  of  the  huge  rings  worn 
by  the  Hindoo  devotee,  he  applied  to  Cullerier  for 
advice,  who  promi)tly  removed  it  with  tlie  knife.^"  The 
writer  has  seen  tliree  cases,  during  his  practice,  of  spon- 
taneous circumcision,  ail  resulting  from  pliymosis  as  a 
secondary  affection  to  venereal  disease.  The  first  case 
occurred  wlien  he  first  entered  into  practice;  it  was  in 
a  young,  stout,  and  full-blooded  man  with  a  Adolent 
gonorrlio3a.  There  was  much  swelling  and  tumefactioii 
of  the  whole  organ,  which  seemed  to  be  A^ery  rebellious 
to  all  treatment.  At  one  of  his  morning  visits  he  was 
horrified  to  observe  a  transverse,  livid  mark  at  what 
seemed  to  be  the  middle  of  the  organ  ;  by  noon  this  had 
gained  ground  to  the  right  and  left  and  there  was  no 
mistaking  that  it  meant  nothing  less  than  mortification. 
Never  having  seen  a  case,  the  natural  uncomfortable 
conclusion  was  that,  through  some  cause  or  other  or  the 
natural  result  of  excessive  congestion,  the  man  was 
about  to  lose  one-iinlf  of  his  organ  ;  and  Burnside  at 
Fredericksburg  wns  in  no  grenter  state  of  suspense  and 
uncertainty  with  the  fate  of  the  Army  of  the  Potomac 
on  liis  hands  than  the  writer  must  acknowledge  he  was 
with  this  man  and  his  organ  apparently  liquefying  under 


Injibulation,  Muzzling,  and  other  Curious  Practices.     59 

his  treatment.  The  surprise  can  be  better  imagined 
than  described  when,  on 'the  following  morning,  the 
glans  made  its  appearance  safe  and  sound  out  of  its 
imprisonment,  and  at  right  angles  with  the  organ  there 
hung  the  prepuce,  thick  and  as  large  and  as  long  as  the 
penis  itself,  inflammatorjr  deposit  and  inllltration  having 
brought  it  to  that  shape  and  consistence ;  the  glans 
became  completely  uncovered  ;  the  parts  gathered  under- 
neath, where,  in  thff  course  of  some  weeks,  they  had 
shrunk  to  the  size  of  a  walnut,  which  was  afterward 
removed  b}^  the  knife.  In  this  case,  as  in  the  other 
two  cases  observed,  the  corona  was  ver^^  prominent 
and  acted  as  an  internal  tourniquet  by  its  upward 
pressure,  tlie  line  of  demarkation  being  on  the  dorsum 
in  the  three  cases  noted. 

That  such  cases  would  suggest  circumcision  is  not 
only  probable  but  possible,  as  it  would  point  out  the 
manner  of  performing  the  operation  ;  but,  in  the  cases 
of  the  Australian  savages,  who  performed  an  artificial 
hyi)ospadias  on  themselves  for  a  specific  purpose,  re- 
quiring a  knowledge  of  the  anatomical  relation  of  the 
parts  as  well  as  of  their  physiological  functions,  it  is 
liard  to  speculate  how  the  operation  was  first  suggested 
or  how  it  came  at  first  to  be  performed.  As  a  Malthu- 
sian  agent  it  is  certainly  an  operation  of  the  highest 
merit,  and  it  should  be  introduced,  by  all  means,  in  the 
United  States,  where  tlie  wealth  and  luxurj'  in  which 
the  people  dwell  is  fast  drifting  them  toward  the  same 
whirlpool  that  engulfed  Rome,  which  was  preceded  by 
a  dislike  to  have  children.  Whenever  the  writer  sees 
the  poor  anaemic,  broken-down  victim  of  many  mis- 
carriages, he  cannot  help  but  feel  that,  if  the  laws 
of  the  Damiantina  River  saA'ages  were  enforced  on  their 
husbands,  it  would  be  a  blessing  to  the  poor  women 


60  History  of  Circumcision. 

without  materiall3'  injuring  the  husbands,  who,  in  case 
of  need  of  a  re-establishment  of  the  functions  of  pro- 
creation, might  be  fitted  with  a  vulcanite  plate  for  the 
occasion, — something  like  our  cleft-palate  patients  are 
supplied  witli  a  plate  that  enables  them  to  articulate. 

It  was  the  custom  among  the  Hottentots,  when  first 
discoveied  or  known  to  the  whites,  to  remove  one'  of 
their  testicles.  This  was  supposed  to  enable  them  to 
run  more  swiftly  and  to  be  lighter- footed  in  the  race. 
The -real  reason,  afterward  found,  was  a  mixture  of 
pure  humauitarianism  and  Maltluisianism  boiled  down 
to  Hottentot  ethics.  With  them  a  monorchid  was  not 
supposed  to  beget  twins;  when  twins  are  born  in  the 
family,  tlie  mother  generally  smothers  the  female,  if  one 
iiappens  to  be  such;  if  not,  then  the  feeblest  of  the  two 
is  sacrificed.  In  their  migrator3'  and  nomadic  life  the 
mother  finds  it  impossible  to  either  carry  or  care  for  the 
two  children.  The  male  Hottentot,  rather  than  have 
any  avoidable  infanticide  in  his  family,  or  that  his  wife 
should  go  through  and  suffer  the  annoyance  and  pangs 
of  an  unnecessiiry  and  unprofitable  pregnane}',  gener- 
ously has  one  testicle  removed  ;  this  is  something  that 
the  ordinary  civilized  white  man  would  not  do,  even  if 
his  legitimate  wife  and  all  his  outside  concubines  were 
to  have  twins  or  triplets  every  nine  months;  so  that, 
even  as  strange  as  it  may  appear,  civilization  must  need 
go  to  the  wild  Bushmen  in  search  of  that  grand  old 
Quixotic  chivalry  that  was  in  ancient  times  alwaj'S 
read}^  to  sacrifice  itself  for  the  welfare  of  woman. 

The  old  Greek  and  Roman  statues,  representing  the 
gods  and  athletes  of  ancient  Greece  and  Rome,  are  a 
puzzle  to  many,  owing  to  the  diminutive  and  phimosed 
virile  organ  tiiat  the  artists  have  attached  to  tliem. 
Galen  represents  that  the  disuse  of  the  organ  b^'  the 


Injibulation ,  Muzzling,  and  other  Curious  Practices.     61 

athletes  was  the  cause  of  its  mideveloped  form,  and  that 
as  the  organ  of  these  did  not  figure  in  the  worship  of 
Veuus,  or  participate  in  the  festivals  of  Bacchus,  hut 
was  used  solely  and  simply  for  micturating  purposes, 
impotence  was  often  the  result,  citing  the  case  of  a 
patient  wlio  came  to  consult  him  for  an  obstinate  pria- 
pism resulting  from  veiiereal  excess,  who  met,  in  his 
anteroom,  an  atiilete  who  was  being  treated  for  the 
opposite  condition,  due  to  tlie  too  rigid  continence  to 
which  lie  had  been  for  years  subjected.  Acton  does 
not  believe  that  continued  continence  has  that  effect, 
quoting  Dr.  Bergeret,  wlio  had  long  been  physician  to 
a  number  of  religious  societies,  as  saj'ing  that  lie  had 
never  seen  serious  troubles  of  tlie  organs  of  generation 
in  these  communities,  which  denotes  that  if  they  in- 
dulged in  i)roper  fasting  and  pra3'er  they  were  in  the 
same  condition  of  flaccid  impotence  as  the  athlete  in 
Galen's  anteroom.  Louis  VII,  of  France,  tried  fasting 
and  prayer  in  connection  with  rigid  continence,  and,  as 
a  result,  his  wife,  Queen  Eleonore,  was  divorced  from 
him  and  married  Henry  II,  of  England,  who  had  not 
been  continent.  Hence,  we  see  that  the  old  sculptors, 
whether  wishing  to  represent  Jupiter  or  Pluto,  ^Escu- 
lapius  or  Mars,  a  strongly'  knit  and  muscular  frame  was 
desired,  an  athlete,  gladiator,  or  soldier  being  used  as  a 
model ;  the  small, puerile,  funnel-prepuced  organ  belonged 
to  all  these  muscular  or  well-trained  classes,  was  a  natural 
appendage,  as  enforced  continence  and  the  most  absolute 
chastity  was  the  rule,  to  enforce  which  they  even  resorted 
to  inflbulation.  This  enforced  continence  often  resulted 
in  impotence,  even  before  the  prime  of  life  was  passed, 
accompanied  by  an  inevitable  atropli}'  of  the  male  organ, 
with  the  resulting  prepuce  in  the  shape  in  which  it  is 
found  in  a  boy  of  from  eight  to  twelve  years,  precisely 


62  History  of  Cii'cnmcision. 

as  tliey  are  found  ou  the  statutes.  How  faithful  the 
sculptors  and  artists  were  to  nature  and  life  in  their 
representations  can  well  be  imagined  b}^  a  critical  ex- 
amination of  the  Apollo  Belvidere,  where  the  difference 
of  the  scrotal  position  that  exists  between  the  right  and 
left  testicles  is  carried  out  to  the  minutest  anatomical 
detail.  In  our  age  it  is  hard  to  conceive  wh}'  their 
most  masculine  men  should  be  deified,  and  all  their  gods 
represented  as  the  most  perfect  of  bodil3r  development, 
while  at  the  same  time  the  finest  physical  specimens  of 
manhood  were  doomed  to  a  life  of  the  most  rigorous 
continence.  It  is  also  astonishing  that  all  this  should 
be  done  not  from  any  principle  or  consideration  of 
morality  or  virtue,  but  simply  as  a  means  subservient 
in  producing  at  its  maximum  the  highest  degree  of 
physical  development  and  endurance. 


CHAPTER  YI. 

Attempts  to  Abolish  Circumcision, 

Probably  ho  rite  or  practice  of  a  custom  has  been 
such  a,  loug-standiug  bone  of  contention  as  circumcision  ; 
nor  does  the  Sph_ynx  surpass  this  relic  of  bygone  ages 
in  mj'sterj'.  From  time  immemorial  its  practice  has 
been  the  subject  of  disputes,  and  its  hterature  finds 
oftentimes  its  friends  and  foes  ranged  side  hy  side.  At 
one  time  a  noted  Israelite  and  Voltaire,  the  scoffer  of 
Judaism,  ma}'  be  consulted  on  the  question  as  to  whether 
Israelite  or  Egyptian  is  entitled  to  priority  as  to  its 
original  practice  with  a  like  answer;  and,  again,  Chris- 
tians are  found  who,  after  a  careful  investigation,  will 
accord  this  to  the  Israelites.  In  Rome,  the  persecuted 
Hebrew  was  stopped  on  the  street  and  eompelkd  to 
show  the  mark  of  circumcision,  that  he  might  be  taxed, 
and  in  Turkish  parts  the  Christian  was  subjected  to  the 
same  indignity  to  enable  the  tax-gatlierer  to  harvest  the 
impost  which  he  paid  for  his  libert}'  of  conscience  and 
not  being  circumcised.  When  the  monkish  missionaries 
of  the  Catholic  faith  first  entered  Abyssinia,  they  were 
shocked  to  find  their  converts  insisting  on  their  time- 
honored  practice  of  circumcision  ;  and  later,  when  the 
Propaganda  sent  its  own  missionaries,  they  were  scan- 
dalized to  see  Christians  practicing  what  they  looked 
upon  as  an  infidel  rite;  and  nothing  but  the  most  earnest 
confession  of  faith,  with  the  assurance  that  the  rite  of 
circumcision  was  only  a  physical  remedy,  and  that  in 
their  conscience  it  in  no  wise  possessed  any  religious 
significance,  and  that  neither  did  the3',in  any  sense,  hold 
it  in  any  connection  with  the  sacrament  of  baptism,  per- 
mitted these  Abyssiniaus  to  save  themselves  from  excom- 

3  (63) 


64  History  of  Cii'cumcision. 

munication.  Later  still,  when  an  Abyssinian  bishop  was 
present  in  Lisbon,  the  clergy  of  the  cit}'  refused  him  the 
right  of  celebrating  the  sacrifice  of  the  holy  mass  in  the 
Cathedral  of  Lisbon,  on  the  ground  tliat  he,  having  been 
circumcised,  was  no  better  than  a  heretic.  The  Abys- 
sinian Christians  still  practice  the  rite  at  the  present  day. 
The  Turks,  although  very  fanatical  and  greater  prose- 
lyters  than  the  Christians  of  Rome,  seem  now  and  then 
to  relax  in  favor  of  general  utility,  as  we  find  Bajazet  II 
writing  to  the  Pope,  Alexander  VI,  supplicating  his 
Holiness  to  confer  a  cardinal's  hat  on  the  Archbishop 
of  Aries  as  a  special  favor  to  the  Turkish  emperor,  as 
lieknew  that  the  archbishop  had  a  secret  leaning  toward 
Mohammedanism.  As  the  clergy  of  those  days,  from 
the  Holy  Father  down,  were  more  politicians  than  fol- 
lowers of  the  humble  Nazaiene,the  heaven  of  Mohammed 
had  probabl.y  more  attractions  for  their  taste  than  the 
ideal  Christian  paradise,  and  it  is  possible  that  the  good 
archbishop  would  have  submitted  to  a  cardinal's  hat 
and  circumcision  at  the  same  time  to  secure  the  good 
tilings  of  this  world  and  of  those  in  the  world  to  come. 
History  also  relates  that  his  most  Christian  majesty, 
Henry  III,  of  France,  as  a  relaxation  to  the  intermin- 
able squabble  between  two  Christian  religions  Mictions 
which  were  rending  France,  and  which  in  the  end  cost 
him  his  life,  actually  wrote  a  letter  to  the  Sultan,  asking 
the  favor  to.be  allowed  to  stand  as  godfather  at  the  cir- 
cumcision of  his  son.  When  it  is  remembered  that  the 
godfather  at  a  Turkish  circumcision  has  to  make  a  strong 
profession  of  Moslem  faith  and  the  answers  as  sponsor 
for  the  child,  and  must  promise  that  the  child  will  be 
faithful  to  the  Koran  and  Mohammed,  it  will  be  seen 
that,  however  much  the  lower  levels  of  humanity  may 
quarrel   over   trifles,   the   heads    of    the    people   easily 


Attempts  to  Abolish  Circumcision.  65 

accommodated  tliemselves  to  vMy  existing  circumstances. 
Friar  Clemens  might  as  well  have  let  such  a  liberal- 
minded  monarch  live,  as  any  of  the  existing  churches 
could  easily  have  got  along  Avitli  him. 

On  the  other  hand,  we  have  the  remarkable  tenacity 
to  custom  and  habit  in  this  regard,  as  exhibited  by  the 
Moslems,  who,  although  having  neither  ordinance  nor 
authority  for  its  performance,  either  in  their  law,  creed, 
or  in  any  order  from  their  prophet,  still  no  more  zealous 
circumciser  exists  than  the  son  of  Islam,  who  exacts 
from  all  proselytes  the  excision  of  the  prepuce.  Moham- 
med was  circumcised  in  his  boyhood,  and,  although  he 
did  not  order  its  performance  to  his  followers,  he  did 
not  see  fit  to  proscribe  a  custom  so  general  to  the 
Arabians,  where  the  greater  development  of  the  prepuce 
probably  renders  circumcision  a  necessit}'.  From  the 
same  reason  it  is  easy  to  perceive  wh}'  the  rite  has  found 
such  general  observance  among  the  Africans,  who  are 
as  noted  for  long  and  leather^^  prepuces  as  for  their  slim 
shanks.  One  author,  writing  in  1772,  in  a  work  entitled 
"  Pliilosophical  Researches  on  the  Americans,"  treats  the 
subject  in  a  very  intelligent  manner.  His  arguments  are 
both  ingenious  and  plausible.  This  author  looks  upon 
circumcision  as  of  purely  climatic  origin  in  its  inceptive 
causes.  From  a  careful  survey  of  the  natural  history 
of  man  in  his  general  distribution  over  the  globe,  he 
finds  that  circumcision  may  be  said  to  be  restricted  to 
within  certain  boundaries  of  latitude,  equidistant  on 
both  sides  of  the  line.  No  circumcised  peoi)le  have  ever 
inhabited  northern  regions,  and  the  bulk  of  the  circum- 
cised races  are  found  within  certain  climates.  From 
this  reasoning  it  is  easy  to  see  why  the  rite  should  lose 
its  standing  under  certain  climatic  conditions,  unless 
bolstered  up  by   some    religious   significance,  as    it   is 


66  Hidoj^y  of  Circumcision. 

eqimlly  easy  to  foresee  why  it  should  flourish  elsewhere, 
even  without  any  religious  backiug  or  ordinance.  It  is 
well  known  that  in  Ethiopia  and  the  neighboring  coun- 
tries, excrescences  and  elongation  of  either  the  prepuce 
or  n3'niph8e  are  as  probable  as  the  existence  of  an  en- 
larged thyroid  gland  or  goitre  among  the  inhabitants  of 
some  of  the  valleys  of  Switzerland  or  of  those  of  the 
Tyrol.  According  to  the  author  of  the  treatise  just 
quoted,  circumcision  would  be  nothing  more  than  a 
remedy  to  repair  the  evils  that  a  fault}'  construction  of 
the  human  body  developed  in  certain  climatic  conditions. 
With  the  Israelites  it  is  observed  as  a  religious  rite, 
although  they  are  not  strangers  to  the  physical  benefits 
that  circumcision  confers  upon  them  ;  the  fact  that  even 
where  no  prepuce  exists,  as  sometimes  happens,  the  cir- 
cumciser  nevertheless  goes  on  with  the  rite,  being  satisfied 
with  drawing  a  few  drops  of  blood  from  the  skin  near 
the  glans,  stamps  the  operation  essentially  as  being  a 
religious  rite.  Persecutions  have  signally  failed  to  sup- 
press its  performance  b}^  those  of  the  Hebrew  faith. 
Beginning  with  the  decree  of  Antiochus,  167  B.C.,  which 
consigned  every  Hebrew  mother  to  death  who  dared  to 
circumcise  her  oflspring,  they  have  not  ceased  to  suffer 
in  defense  of  their  rite.  Adrian,  among  other  repres- 
sive measures,  forbade  circumcision  ;  under  Antonine 
this  edict  was  still  enforced,  but  he  afterward  recoiled 
it  and  gave  to  the  Hebrews  the  right  of  observing  their 
religious  rites.  Miircus  Aurelius,  however,  revived  the 
edict  of  Adrian.  Heliogabalus,  who  ascended  the  Ro- 
man throne  iu  the  3'ear  218  a.d.,  was  himself  circum- 
cised. During  the  reign  of  Constantiue  all  the  laws 
that  interfered  with  Hebraic  rites  were  renewed,  with 
the  addition  that  any  Hebrew  who  should  circumcise  a 
slave  should  suffer  death.     Under  the  sway  of  Justinian, 


AttemjJts  to  Abolish  Circumcision.  67 

in  the  sixth  centuiy,  the  persecutions  against  tliese 
people  were  so  oppressive  that  a  Hebrew  was  not  allowed 
to  raise  or  educate  his  own  child  in  the  faith  of  his 
fathers.  In  the  seventh  century-,  the  augurs  havino- 
prophesied  the  ruin  of  the  Roman  Empire  bj^  a  circum- 
cised race  to  the  emperor  Heraclius,  the  persecutions 
were  renewed  against  these  unfortunate  people.  In  tliini 
century,  Hebrews  refusing  baptism  suffered,  banishment 
and  confiscation  of  all  their  property  ;  they  were  oblioed 
to  renounce  the  Sabbath,  circumcision,  and  all  Hebraic 
rites  if  they  wished  to  remain.  About  this  period  the 
success  of  the  Saracens  induced  persecutions  of  the 
Hebrews  in  Spain,  where  their  children  were  taken  away 
from  them  that  the3-  might  be  raised  in  the  Christian  re- 
ligion. In  the  fifteenth  century  they  suffered  the 
greatest  persecution  and  mart3Mxlom  at  the  hands  of  the 
Spanish  Inquisition.  The  persecutions  above  cited  were 
national  and  governmental  persecutions  levelled  directly" 
at  the  Jewish  nation  and  creed  ;  the  persecutions  that 
they  momentarily  suff"ered  at  other  times  had  no  signifi- 
cation beyond  the  exhibition  of  popular  spite  and  furj^, 
but  those  above  cited  Avere  moves  calculated  to  extirpate 
the  creed,  if  not  the  people,  from  off"  the  face  of  the 
globe.  If  repressive  measures  are  of  any  avail,  circum- 
cision as  an  Hebraic  rite  should  now  have  no  existence. 
Its  present  existence  and  observance  show  a  vitality 
that  is  simply  phenomenal ;  its  resistance  and  apparent 
indestructibilit}"  would  seem  to  stamp  it  as  of  divine 
origin.  No  custom,  habit,  or  rite  has  survived  so  many 
ages  and  so  man}'^  persecutions  ;  other  customs  have  died 
a  natural  death  with  time  or  want  of  persecution,  but 
circumcision,  either  in  peace  or  in  war,  has  held  its  own, 
from  the  misty  epochs  of  the  stone  age  to  the  present. 
There  is   something  pathetic  and  soul-appealing  in 


68  History  of  Circumcision. 

contemplating  the  early  Christians  forced  to  worship  in 
the  catacombs  of  Rome,  hunted  like  wild  animals  in 
their  subterranean  burrows,  and  then  given  the  choice 
of  making  offerings  to  the  heathen  gods  or  being- 
thrown  into  the  iai'ena  as  prey  to  wild  beasts  ;  so  are  we 
stirred  when  we  think  of  tlie  Spanish  Jew,  who  had 
made  Spain  his  home  for  centuries,  being  driven  into 
exile  in  such  droves  that  no  country  could  receive 
them;  we  see  them  perishing  of  hunger  by  the  thousands 
on  the  African  coast,  and  dying*  of  starvation  on  the 
quays  of  the  ports  of  civilized  Italy.  That  many,  through 
all  these  trials,  were  forced  to  embrace  other  religions  is 
not  astonishing.  In  Si)ain  npostacy  was  to  no  purpose, 
as  the  Inquisition  could  not  be  expected  to  split  hairs  in 
regard  to  an  apostate  Jew,  when  it  sent  the  best  of  Gothic 
blood,  raised  in  tlie  Catholic  faith,  to  the  auto  da  fe  or 
the  scaffold, — the  rack  respecting  neither  faith  nor  pro- 
fession that  fell  into  its  clutches.  In  milder  persecu- 
tions, however,  he  escaped  by  outwardly  conforming  to 
the  demands  of  his  oppressors  ;  and  history  tells  us  of  the 
circumcisions  secretly'  performed  on  the  dead  Jew,  that 
the  spirit  of  the  law  of  their  fathers  might  be  carried  out. 
In  other  cases,  threatened  exile,  confiscation,  or  ex- 
orbitant taxation  drove  them  to  adopt  every  possible  ex- 
pedient to  eradicate  the  sign  of  their  Israelitism  and 
make  attempts  to  reform  a  prepuce.  The  first  attempts 
in  tills  line  were  made  during  the  reign  of  Antiochus, 
when  a  number  of  Hebrews  wished  to  become  as  the 
people  about  them  who  were  not  persecuted — fecerunt 
cibi  praeputia.  This  is  no  easy  operation,  and  in  later 
times  by  the  aid  of  appliances,  both  in  Rome  and  in 
Spain,  they  undertook  to  cause  the  skin  to  recover  the 
glans.  Martial,  in  speaking  of  the  instrument  used  in 
Rome,  a  sort  of  a  long  funnel-shaped   copper  tube  in 


Attemjyts  to  Abolish  Circumcision.  69 

which  the  Hebrew  carried  his  virile  oi-gfin,  terms  it 
Judoem  Pondum,  the  weight  of  "which,  by  drawing. down 
the  skin,  was  supposed  iu  time  to  draw  it  down  far 
enough  to  answer  tlie  purpose.  The  apostle  Paul,  in  his 
epistle  to  the  Corinthians,  refers  to  these  practices 
when  he  says,  "Was  any  dne  called  being  circumcised, 
let  him  not  be  uncircumcised."  The  operation  of 
reforming  a  prepuce,  or  of  obliterating  the  marks  of 
circumcision,  does  not  appear  to  have  beeu  a  success. 

The  writer  had  one  experience  that  was  interesting. 
On  one  occasion  he  advised  circumcision  for  the  relief 
of  a  reflex  nervous  disease,  in  a  tali,  athletic  Austrian 
sailor  from  the  Adriatic  ;  although  the  nature  of  the 
operation  was  explained  to  the  man,  he  evidently  did 
not  appreciate  its  full  nature  and  importance  until  a 
a  sweeping  cut  with  a  scalpel  left  the  excised  prepuce  in 
the  operator's  hand.  Most  Adriatic  sailors  have  sailed 
up  the  Bosphorus  and  are  more  or  less  familiar  with 
both  the  Grreek  and  Turkish  nations ;  the  latter  they 
despise  with  gusto,  "po?•c/;^  c^i  Turci^^  being  the  affec- 
tionate appellation  they  bestow  on  their  national  neioh- 
bors.  No  sooner  did  he  perceive  the  real  condition  of 
affairs  than  he  began  to  beat  his  head,  saying  that  he 
was  disgraced  forever,  as  he  never  would  dare  to  asso- 
ciate with  his  countrymen  again,  as  he  would  be  liable 
to  be  taken  for  a  porcho  di  Turco  ;  his  frenzy  increased 
to  such  a  pitch  that  to  spare  any  unpleasantness  it  was 
deemed  advisable  to  replace  the  prepuce,  which  was 
done  accordingly,  the  man  making  a  tolerable  good 
recovery,  as  far  as  the  grafted  prepuce  was  concerned. 
It  required  a  secondary  operation  to  overcome  some 
cicatricial  contraction,  and,  on  the  whole,  he  had  a  very 
serviceable  prepuce  ;  but,  what  was  more  to  the  point, 
it  prevented  his  ever  being  mistaken  for  a  Turk. 


CHAPTER  YII. 

Miracles  and  the  Holy  Prepuce. 

What  strange  fancies  have  circled  tliemselves  abont 
the  subject  of  generation  or  its  organisms  during  the 
different  stages  of  moral  civilization  since  the  world 
has  existed  1  The  efforts  in  this  regard  among  different 
creeds  have  been  something  peculiar.  Neither  Moham- 
medans nor  Hebrews — both  zealous  circumcisers — ever 
went  to  the  lengths  reached  by  Christian  churches  and 
their  followers  in  some  particulars  concerning  this  rite ; 
this  being  especially  strange  when  it  is  considered  that 
the  new  creed  was  the  one  that  abolished  the  rite  and 
tlirough  wliich  the  Jews  suffered  such  cruel  and  nnjust 
persecutions.  Tlie  earlj^  Christian  Cliurcli  celebrated 
and  continues  to  celebrate  the  Feast  of  Circumcision, 
and  histor^^  relates  some  sti'ange  events  in  connection 
witli  this  circumcision.  Having  abolisiied  and  repudi- 
ated the  rite,  it  would  seem  inconsistent  that  it  should 
celebrate  its  performance  on  an^^  occasion  and  consider 
such  an  event  sufficiently  memorable  that  its  occurrence 
should  excite  the  veneration  of  the  church  and  be  the 
means  of  exciting  the  pious  zeal  of  the  faithful.  The 
strangest  events  in  this  connection  are  still  more  mys- 
terious and  incomprehensible,  if  not  amusing,  the  only 
excuse  for  the  occurrence  being  the  greedy  thirst  for 
relics  of  any  and  all  kinds  that  in  the  middle  ages 
pervaded  Europe. 

At  some  remote  period — in  the  thirteenth  or  four- 
teenth century — the  abbey  church  of  Coulombs,  in  the 
diocese  of  Chartres,  in  France,  became  possessed  in 
(70) 


Miracles  and  the  Holy  Prepuce.  *l\ 

some  miraculous  manner  of  the  holy  prepuce.  This 
holy  relic  had  the  power  of  rendering  all  the  sterile 
women  in  the  neighborhood  fruitful, — a  virtue,  we  are 
told,  which  filled  the  benevolent  monks  of  the  abbey 
with  a  pardonable  amount  of  pride.  It  had  the 
additional  virtue  of  inducing  a  subsequent  easy  delivery, 
which  also  added  to  the  reputation  and  pardonable 
vanity  of  the  good  monks.  This  last  virtue,  liowever, 
we  are  told,  came  near  causing  the  loss  to  the  abbey  of 
this  inestimable  prize,  for,  as  a  Frencl  writer  observes, 
a  too  great  reputation  is  at  times  an  unlucky  possession  ; 
at  an}^  rate,  tlie  royal  spouse  of  good  and  valiant  King 
Henry  V — he  of  Agincourt,  whom  England  waded  up  to 
its  knees  in  the  sea  at  Dover  to  meet  on  his  return  from 
that  campaign — had  followed  the  example  of  all  good 
dames  and  was  about  to  give  England  an  heir.  Henry 
then  governed  a  good  part  of  France.  Having  heard 
of  the  wonderful  efficacy  of  the  relic  of  Coulombs,  he 
early  one  morning  thiew  the  good  monks  into  consterna- 
tion by  the  arrival  at  the  convent  gate  of  a  duly 
equipped  herald  and  messenger  from  his  kingship,  ask- 
ing for  the  loan  of  the  relic  with  about  as  much  cere- 
mony- as  Mrs.  Jones  would  ask  for  the  loan  of  a  flat-iron 
or  saucepan  from  her  neighbor,  Mrs.  Smith.  The  queen, 
Catherine  of  France,  was  of  their  own  country  and 
Henry  was  too  powerful  to  be  put  off"  or  refused  ;  there 
was  no  room  for  evasion,  as  the  holy  prepuce  could  not 
be  duplicated  ;  so  the  poor  monks  with  the  greatest  reluc- 
tance parted  with  their  precious  relic,  entrusting  it  into 
the  hands  of  the  xojiiX  envoy,  which  wended  its  way  to 
London,  where  it  in  due  time,  being  touched  by  the 
queen,  insured  a  safe  delivery.  Honest  Henry  then 
returned  the  relic  to  France;  but  so  gi-eat  was  its  repu- 
tation that   royalty  caused  a   special  sanctuary  to  be 


*r2  History  of  Circumcision. 

erected  for  its  reception,  and  a  full  period  of  twent3-five 
years  occurred  before  the  monks  of  Coulombs  again 
regained  possession  of  tlieir  prize,  during  which  period 
the  population  of  the  neighborhood  must  have  suffered 
from  the  natural  increase  of  sterilit}^  and  the  physicians 
must  have  reaped  a  rich  harvest  owing  to  the  increased 
difficulty  and  comj)lications  of  labor  induced  by  the 
absence  of  the  relic.  On  its  return,  the  relic  was  found 
to  have  lost  none  of  its  virtues,  and  the  good  people  and 
monks  were  all  correspondingly  made  happ^^ ;  in  1870, 
when  the  writer  was  in  France,  it  was  still  working  its 
miracles.  Balzac  found  ample  facts  to  found  his  famous 
"  Droll  Stories  "  without  straining  his  imagination. 

So  great  an  attraction  was  not  to  go  without  at- 
tempted rivalry  or  imitators  ;  hence  we  fliid  in  the  "  Dic- 
tionarj^  of  Moreri,"  edition  of  1715,  in  tlie  third  volume, 
at  page  108,  that  several  other  establishments  claim  the 
honor  of  a  like  relic, — nameh'',  the  Cathedral  of  Puy, 
in  Velay ;  the  collegial  church  of  Antwerp ;  the  Abbey 
of  our  Saviour,  of  Charroux;  and  the  Church  of  St. 
John  Lateran,  in  Rome.  All  of  these  have  had  very 
adventurous  histories.  The  Abbey  of  Charroux  was 
founded  by  Charlemagne  in  7So,  and  among  the  relics 
with  which  that  monarch  endowed  the  abbey  the  pi'in- 
cii)al  one  was  a  fragment  of  the  hoi}'  prepuce.  This 
abbey  enjoj^ed  great  reputation,  and  indulgences  were 
granted  b}'  Papal  bull  to  all  those  who  assisted  at  the 
adora,tion  of  the  relics.  In  the  internecine  wat's  of  the 
sixteenth  century  the  abbey  fell  into  the  hands  of  the 
godless  and  heretical  Huguenots  and  the  hoi}'  relic  disap- 
peared. In  1856,  while  some  workmen  were  at  work  de- 
molishing an  ancient  wall  on  the  abbe}'  site,  they  discov- 
ered some  relic  cases.  The  bishop  was  at  once  notified, 
who  immediately  proceeded  to  investigate,  when,  lo  and 


lliracles  and  the  Holy  Prepuce.  tS 

behold  I  there,  sure  enough,  wjis  a  piece  of  desiccated 
flesh,  witli  marks  of  coagulated  blood  ;  nothing  more  or 
Jess  than  the  lost  prepuce — long  lost,  but  now  found. 
It  was  placed  in  charge  of  the  Ursuline  Sisterhood, 
where  it  has  remained  ever  since  undisturbed,  except  by 
a  controversy  in  regard  to  the  propriety  of  the  relic,  in 
which  the  good  bishop  ambled  about  in  the  most  am- 
biguous manner,  the  only  clearly  defincvi  portion  of  his 
dissertation  being  the  one  wherein  lie  laments  "the  de- 
cadence of  that  trul}^  Christian  spirit  which  animated 
the  laity  of  the  middle  ages  witii  a  radiant  zeal.  A  piety 
also  pervaded  those  gentle  Chi-istians  of  former  times, 
who  were  possessed  of  a  religious  instruction  which 
determined  for  them  the  tenets  of  the  creed  and  its 
l)ractices, — a  happy  state  or  condition  of  affairs,  which 
prevented  the  intelligence  of  the  faithful  from  wander- 
ing into  the  sloughs  of  unprofitable  skepticism."  This 
settled  the  question  as  to  the  propriety  of  the  prepuce 
being  converted  into  a  miracle-working  I'elic  ;  at  least,  as 
far  as  the  good  bishop  was  concerned. 

It  would  be  an  injustice  not  to  mention  the  other 
shrines  in  detail  after  the  prominence  that  has  been 
given  to  the  abbeys  of  Coulombs  and  Charroux  ;  so  the 
history  of  another  will  be  given.  We  are  not  told  just 
how  the  Church  of  St.  John  Lateran  in  Rome  first  be- 
came possessed  of  its  holy  prepuce,  but  it  nevertheless 
had  one  ;  also  the  only  authentic  one  in  existence,  like 
all  the  others.  It  disappeared  at  one  of  the  periodical 
sackiugs  that  Rome  has  repeatedly  suffered  at  the  hands 
of  Goth,yandal,or  Christian.  This  time  it  was  the  sol- 
diery of  the  eldest  son  of  the  church — Charles  V — who 
did  the  sacking;  it  was  in  the  3'ear  1527,  a  soldier — 
probably  some  impious,  heathenish  mercenar}^ — broke 
into  the  holy  sanctuary  of  the  church  arid  stole  there- 


74  History  of  Circumcision. 

from  the  box  that  contained  the  holy  relics,  among  them 
the  holjr  prepuce.  These  impious  wretches,  as  a  rule, 
came  to  grief  in  short  order ;  hence  we  are  told  that 
this  mercenary  and  sacrilegious  soldier  was  compelled 
to  secrete  his  box,  when  only  a  short  distance  from 
Rome,  where  the  box  remains  and  the  mercenary  wretch 
disappears,  probably  carried  off  bodil}'^  by  the  devil,  as  he 
deserved.  Thirty  years  afterward  the  box  is  discovered 
by  a  priest,  who,  ignorant  of  its  con-tents,  carries  it  to 
the  lady  on  whose  domain  it  was  found.  On  being 
opened  it  was  found  to  contain  a  piece  of  the  anatomy 
of  Saint  Yalentine,  the  lower  jaw  of  Saint  Martha,  with 
one  tooth  still  in  place,  and  a  small  package  upon  which 
the  name  of  the  Saviour  was  inscribed.  The  lady 
picked  up  the  package,  when  immediately^  the  most  fra- 
grant odor  pervaded  the  apartment,  being  exhaled  by 
the  miraculous  packet,  while  the  hand  that  held  it  was 
seen  perceptibly  to  swell  and  stiffen ;  investigation 
proved  it  to  be  the  holy  prepuce  stolen  b}^  the  miscreant 
mercenary  from  St.  John  Lateran.  It  is  related  that  in 
1559,  a  canon  of  tlie  church  of  St.  John  Lateran,  im- 
pelled  by  a  worldl}'-  curiosity  nntempered  by  pietj^, 
undertook  to  make  a  critical  examination  of  this  relic, 
in  the  process  of  which,  to  better  satisfy  himself,  he 
had  the  indiscretion  to  break  off  a  small  piece  ;  instantly 
the  most  dreadful  tempest  broke  over  the  place,  followed 
by  crashing  peals  of  thunder  and  blinding  flashes  of 
lightning ;  then  a  sudden  darkness  covered  the  countr\^, 
and  the  luckless  priest  and  his  assistants  fell  flat  on  their 
sacerdotal  noses,  feeling  that  their  last  hour  had  ar- 
rived.^' 

Wonderful  and  miraculous  cures  are  performed  at 
these  shrines,  and  some  of  the  cures  are  of  a  nature 
that  would  baffle  the  intelligence  of  the  most  learned 


Miracles  and  the  Holy  Prepuce.  75 

mind  to  ascertain  the  intricate  and  devious  way  that 
nature  must  at  times  journe}'  to  accomplish  some  of 
these  changes.  The  writer  well  remembers  seeing,  in  the 
Churcli  of  Corpus  Christi,  in  Turin,^^  a  long  hall,  cov- 
ered, from  marble  pavemeut  to  ceiling,  with  votive 
tablets,  after  the  manner  inaugurated  in  the  old  temples 
of  Greece.  Moderu  votaries  have  the  advantage  of 
being  able  to  record  their  cure,  safe  A'enture  or  escape 
from  peril,  b}^  means  of  faithful  representation  of  the 
event  in  painting  or  drawing,  as  the  material  and  art  is 
more  common  now  than  in  the  days  of  ancient  Greece, 
who  recorded  its  cures  by  simple  inscription  in  lacoiiic 
terms.  Modern  medicine  labors  under  the  disadvantage 
of  presuming  that  the  people  are  endowed  with  an  in- 
telligence that  was  unknown  to  ancient  or  mediaeval 
people,  when,  in  fact,  the  people  are  as  credulous  and 
as  subject  to  imposition  as  they  were  in  the  earlier 
centuries  of  the  present  era.  With  all  its  supposed 
superior  intelligence,  there  is  no  fatter  pasture  for 
quacks  and  impostors  than  that  presented  Ijy  the  people 
of  the  United  States.  Whenever  I  see  the  poor,  intelli- 
gent, broad-minded  physician  struggling  along,  barely 
able  to  procure  for  himself  the  necessaries  required  to 
maintain  himself  with  proper  books  and  appliances, 
while  the  itinerant  quack  or  dogmatic  practitioner  rolls 
in  undeserved  affluence,  I  question  the  wisdom  of  our 
ethical  code.  Braddock,  at  the  Monongahela,  scorned 
to  have  his  regulars,  who  had  fought  under  Marlbor- 
ough and  Eugene,  break  ranks  before  a  lot  of  breech- 
clouted  savages,  and  take  shelter  that  the  nature  of  the 
ground  and  the  trees  could  afford,  thinking  it  an  unfit 
action  for  men  who  had  faced  the  veterans  of  Louis 
XIV  on  many  a  hard-fought  European  field.  I  some- 
times think  that  if  oar  regulars  were,  for  only  a  season, 


76  History  of  Circumcision. 

to  follow  the  example  of  the  provincial  militia  at  that 
battle,  it  would  be  better  for  the  country,  the  people, 
science,  and  last,  but  not  the  least,  for  the  profession. 
The  theory  that  we  should  not  counsel  with  quacks  is 
altogether  mischievous  and  fallacious,  although  right 
and  rigidly  orthodox  in  its  intent ;  were  we  to  counsel 
and  meet  these  gentry,  we  should  exjoose  their  ignorance 
and  assumption,  and  we  should  not  be  exposed  to  the 
charge  of  jealousy  and  of  fear  to  meet  them  in  consulta- 
tion. I  remember  on  one  occasion  a  client  went  to  a 
lawyer  for  advice  as  to  how  he  might  dispossess  some 
parties  who  had  some  adverse  claim  to  some  property 
which  he  owned,  after  due  deliberation  and  a  pro- 
tracted siege  of  the  house,  in  the  vain  hope  of  gaining 
admittance;  the  law^'er  advised  his  client  to  go  and 
nail  up  all  exits  and  fasten  them  in,  which  had  the  effect 
of  driving  them  out.  So  with  our  profession — we  should 
not  neglect  an  opportunity  of  meeting  a  quack  in  con- 
sultation, regardless  of  the  nature  of  the  case  ;  it  is  the 
only  way  to  nail  them  up  ;  as  it  is,  we  have  simply 
chained  up  the  shepherd-dog  and  given  the  wolves 
full  play. 

The  French  Guards  at  Fontenoy,  who  out  of  courtesy 
refused  to  fire  first  on  the  English,  may  have  been  very 
ethical  and  chivalrous,  but  the_y  were  very  foolish,  as  the 
English  discharge  nearly  swept  them  from  the  field,  and 
but  for  the  Irish  Brigade,  who  knew  no  ethics,  Louis  XV 
would  in  all  likelihood  have  followed  the  example  of 
King  John,  who,  after  Crecy,  visited  England  for  a 
season.  A  disregard  of  ethics  gave  Copenhagen  to 
LordNelson,who  insisted  on  looking  at  Admiral  Parker's 
signal  to  withdraw  from  action  with  his  sightless  e3'e, 
which  could  not  see  it.  A  fear  of  disregarding  ethics  lost 
to  Grouch}'  the  chance  of  assisting  Napoleon  at  Waterloo. 


Miracles  and  the  Holy  Prepuce.  TY 

[n  our  strife  against  ignorance  and  quacker}' the  profes- 
sion  should  follow  the  general  plan  of  action  usually 
adopted  by  Lord  Nelson — lie  alongside  of  whom  ^'ou  crn 
and  sink  or  capture  your  enemy  ;  let  each  man  do  his 
duty ;  never  mind  any  general  plan.  A  reverse  to  this 
mode  of  fighting  invariably  lost  the  battle  to  the  French 
and  Spaniards,  who  were,  as  a  rule,  all  tied  up  in  ethical 
red  tape.  Our  profession  is  broad,  intelligent,  and  fear- 
less ;  we  do  not  profess  any  exclusive  dogma,  and  should 
not,  therefore,  exclude  persons;  as  a  large  ship  throws 
its  grappling-irons  on  to  its  adversary,  we  should  alwaA's 
seek  an  opportunit}'  to  meet  these  gentry  when  practi- 
cable. As  it  is,  we  have  placed  them  on  the  vantage- 
ground  of  appearing  as  being  persecuted  ;  our  ethics 
need  circumcising  in  this  regard,  and  the  prepuce  of 
exclusion  should  be  buried  in  the  sands  of  the  desert. 

Moreover,  we  often  are  apt  to  learn  something  from 
even  the  most  ignorant  of  these  men.  Rush  investigated 
the  nature  of  a  cancer-cure  by  not  refusing  to  meet  and 
talk  with  one  of  this  kind  ;2^  Fothergill  learned  from  nn 
old,  unlicensed  practitioner  that  there  was  a  knowledge 
important  to  the  pliysician  beyond  that  picked  up  in  the 
pathological  ]al)oratory  or  the  study  of  microscopv  ;  and 
that  the  practiced  eye  of  an  otherwise  unlearned  man 
could  detect  that  there  were  general  ph3'sical  signs  thnt 
negatived  the  unfavorable  prognosis  suggested  by  the 
presence  of  tube-casts.^^  It  is  related  of  Sir  Isaac 
Newton,  that  while  riding  homeward  one  day,  the 
weather  being  clear  and  cloudless,  in  passing  a  herder 
lie  was  warned  to  ride  fast  or  the  shower  would  wet  him. 
Sir  Isaac  looked  upon  the  man  as  demented,  and  rode 
on,  not,  however,  without  being  caught  in  a  drenching 
shower.  Not  being  able  to  account  for  the  source  of 
information  throuirli  which  the  rustic  had  gained   his 


78  History  of  Circumcision. 

knowledge,  he  rode  back,  wet  as  he  was,  to  learn  some- 
thing. "  M3'  cow,"  answered  the  man,  "  alwajs  twists 
her  tail  in  a  certain  way  just  before  a  rain,  3'our  Worship, 
and  she  so  twisted  it  just  before  Isawyou."^^  Although 
twisting  cow-tails  do  not  figure  in  his  "  Principia,"  it  is 
yevy  probable  that  such  a  lesson  was  not  without  its 
remote  effects  on  a  mind  like  Newton's.  A  spider  taught 
a  lesson  to  one  of  Scotland's  kings  ;  so  that  one  man  may 
learn  something  from  another. 

Professor  Letenneur,  of  the  Medical  School  of 
Nantes,  in  his  "•  Causerie  a  propos  de  la  Circoncision," 
mentions  that  the  Convent  of  Saint  Corneille,  in  Com- 
piegne,  claims  to  possess  the  identical  instrument  with 
which  the  Holy  Circumcision  was  performed.  Such  a 
holy  relic  must  have  been  unusually  potential  in  per- 
forming many  miracles. 

In  this  connection  it  will  not  be  amiss  to  notice  the 
lapping  over  that  the  old  phallic  worship  and  idea  has 
made  on  the  new  religions.  It  is  also  as  interesting  to 
observe  how  the  human  mind  still  leans  toward  observ- 
ances and  ideas  which  are  believed  to  belong  to  a  solely 
pagan  i)eople.  IIargra\e  Jennings,  in  a  chapter  devoted 
to  phallic  worship  among  the  ancient  Gauls,  gives  man}'- 
interesting  and  curious  examples,  the  first  example  that 
he  notices  being  that  of  Saint  Foutin  (from  whom  the 
very  expressive  French  word  '■'■  f outre''''  is  taken). 
Foutin  Avas  the  first  Christian  bishop  of  Lj'ons,  and 
after  his  death,  so  intimately  was  priapic  worship  inter- 
mingled with  the  religion  or  theology  of  the  Gauls,  that 
somehow  the  memory  of  St.  Foutin  and  the  old,  de- 
throned Priapus  became  commingled,  and  finally  the 
former  was  unconsciously  made  to  take  the  place  of  the 
latter.  St.  Foutin  was  immensely  popular.  He  was 
believed  to  have  a  wonderful  influence  in  restoring  fer- 


Miracles  and  the  Holy  Prepuce.  79 

tility  to  barren  women  and  vigor  and  virility  to  impo- 
tent men.  It  is  related  that,  in  the  church  at  Varages, 
in  Provence,  to  such  a  degree  of  reputation  had  the 
shrine  of  this  saint  risen,  it  was  customary  for  the 
afflicted  to  make  a  wax  image  of  their  impotent  and 
flaccid  organ,  which  was  deposited  on  the  shrine.  On 
windy  daj's  the  beadle  and  sexton  were  kept  busj^  in 
picking  up  these  imitations  of  decrepit  and  penitent 
male  me'inbers  from  the  floor,  whither  the  wind  wafted 
them,  much  to  the  anno3'anee  and  disturbance  of  the 
female  portions  of  the  congregation,  whose  devotions 
are  said  to  have  been  sadly  interfered  with.  At  a  church 
in  Embrun  there  was  a  large  phallus,  which  was  said  to 
be  a  relic  of  St.  Foutin,  The  worshippers  were  in  the 
habit  of  offering  wine  to  this  deit}', — after  the  manner 
of  the  earlj'  Pagans, — the  wine  being  poured  over  the 
head  of  the  organ  and  caught  underneath  in  a  sacred 
vessel.  This  was  then  called  "  holy  vinegar,"  and  was 
believed  to  bean  efficacious  remed}'  in  cases  of  sterility, 
impotence,  or  want  of  virility. 

Near  the  city  of  Bourges,  at  Bourg  Dieu,  there 
existed,  during  the  Roman  occupation  of  Gaul,  an  old 
priapic  statue,  which  was  worshipped  by  the  surround- 
ing country.  I'he  veneration  in  which  it  was  held  and  the 
miracles  with  which  it  was  accredited  made  it  impolitic  as 
well  as  impossible  for  tlie  earl_y  missionaries  and  monks 
to  remove  it ;  it  would  have  created  too  mucli  oppo- 
sition. It  was  therefore  allowed  to  remain,  but  gradu- 
ally changed  into  a  saint, — St.  Guerluchon,— which, 
however,  did  not  detract  any  from  its  former  merit  oi 
reputation.  Sterile  women  flocked  to  the  shrine,  and 
pilgrimages  and  a  set  number  of  da3^s  of  devotion  to 
this  saint  were  in  order.  Scrapings  from  this  statue 
infused  in  water  were  said  to  make  a  miraculous  drink 


80  History  of  Circumcision. 

whicli  insured  conception.  Similar  slirines  to  this  same 
saint  were  erected  at  other  places,  and  we  are  told  that 
the  good  monks,  who  must  have  had  an  intense  and 
lively  interest  in  seeing  that  the  population  was  in- 
creased, were  kept  busy  supplying  the  statues  with  new 
members,  as  the  women  scraped  away  so  industriously, 
either  to  prepare  a  drink  for  themselves  or  for  their  hus- 
bands, that  a  phallus  did  not  last  long.  At  one  of  these 
shrines,  so  onerous  became  the  industry  of  replacing  a 
new  phallus  to  the  saint,  that  the  good  monks  placed  an 
apron  over  the  organ,  informing  the  good  women  that 
thereafter  a  simple  contemplation  of  the  sacred  organ 
would  be  sufficient ;  and  a  special  monk  was  detailed  to 
take  special  charge  of  this  apron,  which  was  only  to  be 
lifted  in  si)ecial  cases  of  sterilit3^  By  this  innovation 
the  good  monks  stole  a  march  on  their  brothers  in  like 
slirines  in  other  localities,  such  as  tliose  of  St.  Grilles,  in 
Brittau}^,  or  St.  Rene,  in  Anjou,  where  the  old-fashioned 
scraping  and  rei)lacing  still  was  in  vogue.  Near  the 
seaport  town  of  Brest,  in  Brittany,  at  the  shrine  of  St. 
Giiignole,  the  monks  adopted  a  new  expedient.  They 
bored  a  hole  through  the  statue,  through  which  a  phallus 
was  made  to  project  horizontally  ;  as  fast  as  the  devo- 
tees scraped  away  in  front  the  good  monks  as  industri- 
ously pushed  forward  the  wooden  peg  that  formed  the 
phallus,  so  that  it  gave  the  member  the  miraculous 
ai)pearance  of  growing  out  as  fast  as  scraped  off,  which 
greatly  added  to  its  reputation  and  efficacy.  The  shrine 
continued  in  great  vigor  until  the  middle  of  the  last 
century.  Delanre  mentions  a  similar  shrine  at  Puy, 
also  in  France,  which  existed  up  to  the  outbreak  of  the 
French  Revolution.  The  scrapings  in  this  case  were 
immersed  in  wine,  and  the  guardians  of  the  statue  saw 
to  it  that  no  amount  of  paring  or  scraping  should   re- 


Miracles  and  the  Holy  Prepuce.  81 

move  from  the  saint  any  of  that  appearance  of  vigoi'  or 
virility  which  his  great  reputation  demanded,  this 
being  done  by  a  similar  procedure  as  followed  at  the 
church  near  Brest,  one  of  the  attendants  having  been 
sent  to  investigate  into  the  marvelous  growth  of  the 
Brest  phallus. 


CHAPTER  YIIL 
History  op  Emasculation,  Castration,  and  Eunuchism. 

For  the  earliest  records  in  regard  to  emasculation 
we  must  go  back  to  m^ythological  relations.  In  the  old 
legendary  lore  of  ancient  Scandinavia  or  of  Gerinan3^, 
the  loves  and  hatreds  of  their  seini-m^ythological  heroes 
and  heroines  space  over  many  romantic  incidents  before 
reaching  a  cidmination.  Tlie  swiftly'  flowing  Rhine, 
with  its  precipitous  banks,  eddies,  and  rapids  ;  the  broad 
and  more  majestic  Danube  or  Elb;  the  broad  meadows 
and  Druidical  groves  on  its  hilly  slopes  and  stretches 
of  dark  and  gloomy  forest, — all  conspired  to  people  the 
fancy  with  elfs,  gnomes,  fairies,  and  goblins,  who  were 
more  or  less  intermingled  in  all  the  episodes  that  en- 
gaged their  semi-mythological  heroes.  This  helped  to 
fill  in  all  their  deeds  with  entertaining  incidents  ;  their 
halls  and  castles  were  made  necessary  accessories  by  the 
rigors  of  the  climate,  as  well  as  were  the  beeiy  feasts  and 
carousals  with  the  inspiration  of  monotonous  song  also 
rendered  necessaries  bj'^  the  same  element ;  hence,  we 
have  various  incidents,  either  entertaining  or  exciting, 
connected  with  their  legendary  tales,  acting  like  periods 
of  intermission  between  their  love  scenes,  spites,  hatreds, 
murders,  and  general  cremations.  From  such  material 
and  such  opportunities  it  was  comparatively  easj'^  for 
Wagner  to  construct  the  thrilling  and  interesting  in- 
cidents that  compose  his  opera  on  the  legend  of  the 
Nibelungenlied. 

The  Grecian  landscape  and  topography  does  not 
permit  of  such  richness  of  romantic  incidents  or  details, 
(82) 


Emasculation,  Castration,  and  Eunuchism.         83 

ail}'  more  than  the  love-making  of  tlie  iiiifortuuate  spider 
■who  is  deA'oured  by  his  spideiy  Cleopatra  at  the  end  of 
his  first  sexual  embrace  could  furnish  an^'  incidents  for 
one  of  Amelie  Rives's  spirited  novels ;  so  that  neither 
minstrel  nor  bard  have  recorded  the  details  of  the  first 
emasculating  tragedv,  which  from  all  accounts  was  a 
kind  of  an  Ol3'mpian  Donnybrook-fair  sort  of  a  paricidal- 
ending  tragedy. 

TJnfortunatelj-,  Homer  was  not  tliere  to  describe  the 
event,  or  we  might  have  had  a  "Wagnerian  opera  with  its 
Plutonic  music  to  illustrate  all  its  incidents  ;  or  even  a 
Virgil  could  have  made  it  into  interesting  verses;  but,  as 
it  is,  we  must  content  ourselves  with  the  laconic  recitals 
that  have  been  handed  down  by  tradition,  and,  as  all  the 
Greek  performances  of  those  da^-s  were  marked  by  an 
intense  decisiveness,  with  an  utter  lack  of  circumlocu- 
tion, it  is  probable  that  there  was  not  much  to  relate 
bej'ond  the  bare  facts. 

In  Smith's  "  Dictionary  of  Greek  and  Koman  Biogra- 
phies and  Mythology"  we  find  it  related  that  Uranos,or 
Coelus,  was  the  progenitor  of  all  the  Grecian  gods.  His 
first  children  were  the  Centimanes ;  his  next  progeny 
were  the  Cyclops,  who  were  imprisoned  in  Tartarus 
because  of  their  great  strength.  This  so  angered  their 
mother,  Gaa,  that  she  incited  her  next-born  children, 
the  Titans,  into  a  rebellion  against  their  father,  Uranos. 
In  the  general  turmoil  that  followed  Uranos  was  de- 
posed, and,  so  that  he  would  be  incapable  of  begetting 
any  more  children,  Saturnus,  the  youngest  of  his  sons, 
with  a  sickle  made  from  a  bright  diamond,  successfully 
emasculated  poor  old  Uranos.  The  records  are  not  clear 
whether  the  operation  only  included  the  penis,  or  the 
scrotum  and  contents,  or  whether,  like  the  Turkish  or 
Chinese  taille  a  fieur  de  ventre,  Saturnus  made  a  clean 


84  History  of  Circumcision. 

sweep  of  all  the  genitals;  it  is  probable' that  he  did, 
however,  as  the  members  fell  into  the  sea,  and  in  the 
foain  caused  b^^  the  commotion  from  their  contact  with 
the  element  Yeniis  was  born.  Meanwhile,  the  blood  that 
dripped  from  the  wounded  surface  caused  the  Giants, 
the  Furies,  and  the  Melian  nymphs  to  spring  into  life. 
tJranos  is  also  represented  as  being  the  first  king  of 
Atlantis ;  so  that  the  first  eunuch  was  a  god  and  a  king, 
more  unfortunate  than  any  of  Doran's  heroes,  in  his 
"  Monarchs  Retired  from  Business,"  because  he  was 
more  effectually  retired  from  business  than  any  monarch 
that  Doran  records. 

After  this  the  practice  seems  to  ha^-e  been  adopted 
in  a  general  wa}^ ;  and  the  fnct  that  the  future  proceed- 
ings, of  men  and  things  on  earth  do  not  much  interest 
these  unfortunate  members  of  societ}'  in  an3^  great  de- 
gree, interest  in  worldly  affairs  and  testicles  seemingly 
having  been  as  intimately  connected  in  those  early  and 
remote  days  as  with  us  of  the  present,  it  yaxy  natnrall3' 
followed  that  this  disinterestedness,  as  well  as  the 
docility  and  pliability  which  emasculation  engenders, 
first  suggested  their  use  as  servants  or  in  position  of 
trust,  as  a  eunuch,  having  no  incentive  either  to  run  away 
or  to  embezzle,  would  naturally  be  a  valued  and  trusted 
servant.  In  the  days  of  eunuchism  there  were  no  de- 
faulting bank,  city,  or  county  cashiers, — a  circumstance 
which  would  suggest  that  such  a  condition  should  form 
one  of  the  qualifications  for  eligibility  to  such  offices, 
the  very  opposition  to  any  such  proposal  that  the  class 
would  make  showing  in  itself  the  benefits  that  would 
follow  such  an  innovation,  as  it  would  show  that  the 
class  is  not  possessed  witli  that  total  spirit  of  abnega- 
tion requisite  in  the  guardians  of  public  funds.  The 
requirement  might  be  extended  to  bank-presidents  with 


Emasculation^  Castration^  and  Eunuchism.         85 

benefit,  if  some  Cincinnati  episodes  are  any  criterion. 
It  is  safe  to  assume  that  tlie  bank  that  could  advertise, 
ill  connection  with  its  attractive  quarterly'  or  semi- 
annual statement,  that  the  president  and  cashier  were 
properly-  attested  and  vouciied-for  eunuchs  would  find 
in  the  public  sucli  a  recognition  of  the  fitness  of  things 
tliat  the  patronage  it  would  receive  would  soon  compel 
otlier  banks  to  follow  the  example.  The  procedure 
might,  with  national  benefit,  be  extended  as  an  ordeal 
to  our  legislators  at  tiie  national  capitol,  as  it  would 
do  away  with  the  particular  influential  lobby  so  graphi- 
cally described  in  Mark  Twain's  "  Gilded  Age."  These 
things  or  ideas  are  merely  thrown  out  as  suggestions 
to  be  used  b3'  those  who  wn'ite  those  interesting  articles 
in  the  Forum,  or  the  North  Americayi  or  Fortnightly 
Reviews,  on  government  and  social  reforms,  as  a  perusal 
of  the  man}'  articles  written  in  that  direction  will  con- 
vince any  one  that,  from  a  practical  psj'chological  view 
of  the  matter,  the^-  are  sadly  deJicient.  To  make  those 
ailicles  effective  the  reflex  impressions  made  by  the 
animal  on  the  psj'chological  and  moral  nature  of  man 
should  not  be  neglected. 

Semiramis,  whose  beautj'  and  many  accomplishments, 
assisted  by  the  murders  of  several  of  her  husbands  by 
the  hand  of  the  succeeding  one,  had  this  subjecft  in  hand 
in  a  far  more  practical  manner  than  it  is  generally  forced 
on  the  understanding;  hence  we  see  that  she  was  the 
first  to  introduce  the  use  of  eunuchs  in  the  capacitj^  of 
servants  as  well  as  in  official  positions  in  and  about  the 
palace,  as  well  as  trusting  some  of  the  positions  of  the 
highest  importance  to  the  class.  From  her  epoch,  eu- 
nuchism has  become  an  inseparable  attendant  on  Orien- 
tal despotism,  and  has  so  continued  to  the  present  day. 
Like  yellow  fever,  phthisis,  and  some  diseases,  as  well  as 


86  History  of  Circumcision. 

many  otlier  social  afflictions  and  customs,  ennncbism 
does  not  seem  to  flourish  beyond  certain  degrees  of 
north  and  south  latitudes, — a  Tact  that  probably  assisted 
Montesquieu  to  arrive  at  tlie  conclusion  that  climate 
was  a  powerful  factor  in  all  things. 

Bergmann,  of  Strasburg,  quotes  the  ancient  tradi- 
tions, wherein  it  is  stated  that  man  was  taught  the 
art  of  castration  by  the  brute  creation.  The  hyena  is 
cited  as  having  so  instructed  man  by  the  habit  it  ex- 
hibited of  castrating  its  infant  males  in  removing  the 
testicles  with  its  teetii,  the  habit  being  instigated  by  a 
jealousy,  for  fear  of  future  competition  in  the  exercise  of 
the  procreative  act  on  the  part  of  the  young  males. 
Another  tradition  attributes  its  origin  to  the  castor. 
Bergmann  here  traces  out  the  et}  mological  relation  ex- 
isting between  the  name  of  the  operation  and  that  of  the 
animal  with  that  of  a  Greek  verb  tliat  forms  the  root  of 
castritm^  or  camp  ;  casa,  or  house  ;  castigare,  to  arrange; 
from  whence  also  is  traced  cosmos,  the  world  ;  kastorio, 
the  Greek  for  wishing  to  build,  and  the  Latin  kasturio 
having  the  same  relative  but  a  more  imperative  significa- 
tion ;  kastor,  signifjing  as  loving  to  build  ;  vastitiator, 
Latin  for  arcliitect,  and  casticheur,  old  French  for  con- 
structor. The  tale  or  tradition  in  regard  to  the  self- 
mutilatic)'n  inflicted  by  the  castor  is  traced  to  the  Ara- 
bian merchants  who  purcliased  the  castoreum,  which  was 
imported  from  the  sliores  of  the  Persian  Gulf  and  from 
India.  It  was  called,  also,  by  tlie  Arabs,  chuzyalu-l-bahhr, 
or  testicles  from  bej'ond  the  sea ;  or,  in  French,  testi- 
cules  cfoutre  mer.  These  terms  and  the  tradition  that 
the  castor  on  being  pursued,  knowing  the  reason  of  the 
chase,  was  in  the  habit  of  tearing  out  liis  testicles  and 
throwing  them  at  his  pursuers,  were  invented  b}-  these 
merchants  to  heighten  the  price  and  value  of  the  article 


Emasculation^  Castration,  and  Eunuchism.         87 

intrinsically,  as  well  as  to  make  it  more  interesting  by 
this  peculiar  individuality  of  adventure.  The  Latins, 
believing  and  adopting  the  tradition  as  a  matter  of  fact, 
coined  the  word  castorare,  or  doing  like  the  castor. 
Bergmann  uses  in  this  connection  a  number  of  terms  in 
French  to  denote  diiferent  forms  or  degrees  of  this  mu- 
tilation which  have  no  equivalents  in  English, — for  in- 
stance, chatrure,  as  applied  to  animals,  making  also 
a  distinctive  difference  between  the  meaning  of  the 
French  words  castration  and  cliatrement.  Bergmann  is 
a  decided  evolutionist  as  regards  circumcision  being- 
evolved  from  prior  forms  of  physical  mutilation,  as  will 
be  more  fully  explained  in  the  next  chapter;  the  shaving 
of  the  head  of  a  conquered  people  by  the  Hindoos,  or 
the  shearing  the  royal  locks  of  the  ancient  Frankish 
kings  ;  the  blinding  of  one  eye  of  their  slaves  by  the 
old  Sc\'thians,  or  crippling  one  foot  by  the  division  of 
a  tendon  in  a  captive  by  the  Goths,  he  considers  as  on 
the  same  line  with  the  idea  that  led  to  castration,  the 
ditferent  forms  of  eunuchism,  and  circumcision. ^^ 

From  a  purely  materialistic  and  utilitarian  A'iew  of 
the  subject,  he  observes  tiiat.what  we  call  moral  prog- 
ress and  civilization  owe  their  advancement  more  to 
material  interest  and  cold,  selfish  calculation  than  to 
anj'^  development  of  the  humaiiitarian  sentiments,  and 
that  neither  morality  nor  justice  has  much  to  do  with 
it.  The  evolution  of  the  slave  and  the  marks  inflicted 
npon  him  by  his  fellow  humans  are  the  most  emphatic 
evidences  of  the  justness  of  the  above  proposition.  The 
study  of  the  subject  is  equally  interesting  when  consid- 
ered in  connection  with  the  evolutions  of  the  Christian 
Church.  In  its  divergence  from  Judaism  and  its  benefi- 
cent laws,  both  social  and  moral,  the  Christian  Church 
was  but  Illy  fit  to  cope  with  its  persecutors  of  Pagan 


88  History  of  Circumcision. 

tendencies,  or  to  enforce  an  nn written  law  or  code  of 
morality  or  hygiene  among  an  idolatrous,  barbarous, 
and  ignorant  population  such  as  it  had  to  encounter. 
To  its  professors,  the  formation  of  that  monachism 
whiph  has  been  so  much  misunderstood  and  abused  was 
but  an  inevitable  condition. ^^  Tliese  men  had  not  the 
stead3'  compass  to  guide  them  in  the  path  that  was  pos- 
sessed by  the  Jewish  people.  The  mart^-rdom  of  Clirist 
and  many  of  his  apostles,  and  tiie  teachings  of  the  early 
church,  pointed  to  phj'sical  denials,  castigations,  humilia- 
tions, and  sutierings  as  the  oid^' wa}'^  to  salvation;  all 
pleasures  were  sin  and  all  denials  and  pain  were  looked 
upon  as  steps  to  heaven.  The  climate  pointed  to  sexual 
indulgence  as  the  sum  of  all  happiness,  as  can  readily 
be  inferred  from  the  Mohammedan  idea  of  heaven;  so, 
witli  the  earl}'  Christians  who  were  born  in  the  same 
climates,  the  denials  of  sexual  pleasui'es  were  looked 
upon  as  the  most  acceptable  offering  that  man  could 
make  to  the  Deit\'.  Continence,  celibacy,  infibulation, 
and  even  castration  were  the  conditions  looked  upon  by 
many  of  these  men  as  the  only  means  of  living  a  life  on 
earth  that  would  grant  them  an  eternal  life  in  the  next. 
This  view  of  the  situation  peo[)led  the  deserts  with  a 
lot  of  men  dwelling  in  caves  and  in  huts,  living  on  such 
a  scarce  diet  that  they  barely  existed.  That  many  went 
insane,  and  in  their  frenzy  died  while  roaming  in  these 
solitudes,  we  have  ample  evidence.  The  tortures  and 
impositions  of  the  Pagan  rulers  also  drove  man^^  to  this 
life  or  death. 

Religious  mania  has  caused  man}'  cases  of  self- 
mutilation,  either  to  escape  continued  promptings  and 
desires,  or  simply  from  a  resulting  species  of  insanity. 
Of  the  first,  Sernin^^  reported  to  the  Medical  Societ}' 
of  Paris  the  case  of  a  young  priest  who  had'  castrated 


Emasculation,  Castration,  and  Eunuchism.  89 

himself  with  the  blade  of  a  pair  of  scissors,  and  who 
nearh^  lost  his  life  with  the  subsequent  haemorrhage. 
The  writer  saw  an  analogous  case  on  board  an  American 
war-vessel,  of  which  Dr.  Lj'on  was  surgeon,  in  the 
harbor  of  Havre,  in  the  spring  of  1871,  the  subject  being 
the  ship's  cobbler,  a  religious  fanatic,  who  was  driven 
Insane  by  self-imposed  continence.  We  are  not  sur- 
prised, from  the  lack  of  intelligence  of  the  times,  the 
extreme  but  undefined  views  as  to  religion  that  then 
rnled  men,  that  self-imposed  castration  should  have  been 
sanely  considered  and  carried  into  effect  bv  Origines 
and  his  monks.  The  Cybelian  priesthood  had  formerly 
set  the  example  in  their  Pagan  worship,  and  when  we 
are  told  that  tiie  monks  of  Mount  Athos  accused  the 
monks  of  the  convent  of  a  neigliboriug  island  with  fall- 
ing away  from  grace,  because  they  allowed  hens  to  be 
kept  within  the  convent  inclosure,  we  ma}^  well  believe 
that  Origines  and  his  monks  felt  that  they  were  gradu- 
ally ascending  in  grace  Avhen  they  submitted  to  this 
sacrifice.  As  strange  as  it  may  sound,  self  castration  is 
still  practiced  by  the  Skopts3',a  religious  sect  in  Russia, 
In  justice  to  the  Church,  however,  it  must  be  said  that 
she  neither  asked  for  nor  did  she  sanction  these  per- 
formances, altliough  she  was  not  quick  enough  in  assert- 
ing that  she  recognized  the  same  law  in  regard  to  her 
presb3'tery  that  controlled  that  of  the  Hebraic  priest- 
hood. 

Eunuchism  presents  man}^  contradictor}'-  conditions; 
eunuchs  have  not  alwa^ys  been  the  fat  and  sleek  attend- 
ants on  Oriental  harems  as  tradition  and  custom  places 
them  or  would  have  us  believe  ;  neither  does  the  loss  of 
virilit}'^,  in  a  procreative  sense,  seem  to  have  always 
robbed  them  of  their  A'irility  in  other  senses,  as  we  find 
eunuchs  holding  the  highest  offices  in  the  State  under 


90  History  of  Circumcision. 

the  reigns  of  Alexander,  the  Pfcolemys,  Lysim.ichus, 
Mithrades,  Nero,  and  Arcadius,  The  ennnch  Aristo- 
iiikos,  under  one  of  the  Ptolemys,  and  another,  Narces, 
under  Justinhin,  led  the  armies  of  their  sovereigns. 
These  are,  however,  exceptional  cases  ;  as  a  rule,  the 
result  is  as  we  observe  in  the  domestic  animals, — loss 
of  spirit,  vim,  and  ambition.  The  Chnrch  recognized 
this  result,  and,  while  the  Hebraic  law  excluded  eunuchs 
from  participating  in  the  priesthood  as  being  imperfect 
and  unclean,  the  Church  reproached  Origines  and  his 
mouks  and  excluded  eunuchs  from  its  presbytery  on 
the  ground  that  such  beings  lack  the  moral  and  ph3-sical 
energy  requisite  in  a  calling  that  is  supposed  to  guide 
or  lead  men ;  moreover,  there  are  many  reasons  for 
doubting  that  the  ministers  of  state  and  the  generals  of 
the  reigns  above  mentioned  were  actually  eunuclis  in  the 
full  acceptance  of  the  word.  Among  the  ancients  there 
were  several  methods  of  performing  the  operations  that 
made  the  eunuchs  ;  some  were  more  effectual  than  others. 
From  the  removal  of  all  the  genitals,  or  the  penis 
alone,  or  the  scrotum  and  testicles,  or  removing  onl_y  the 
testicles,  down  to  compression  or  to  distorting  the  sper- 
matic vessels,  or,  as  in  the  case  of  the  Scytliiaus,  who 
often  became  eunuchs  from  bareback  riding,  as  Ham- 
mond describes  a  eunuchism  manufactured  b}^  our 
southwestern  Indians  of  New  Mexico  and  Arizona,  are 
performances  that  left  many  degrees  of  eunuchism  ;  as 
we  find  some  eunuchs  that  not  only  contracted  mar- 
riage, but  engendered  children.  Voltaire  mentions 
Kislav-aga,  of  Constantinople,  a  eunuch  a  outrance, 
with  neither  penis,  scrotum,  nor  anything,  who  owned 
a  large  and  select  harem.  Montesquieu,  in  his  "  Persian 
lietters,"  admits  this  class  of  marriages  as  being  prac- 
ticed,  but  doubts    the    resulting   conjugal   felicity,  es- 


Emasculation,  Castration,  and  E aniichism.         91 

pecially  on  the  part  of  the  wife.  Potiphar's  wife  was 
one  of  these  unfortunate  wives;  no  wonder  that  she 
tore  Joseph's  cloak  in  her  desire.  Juvenal  mentions 
that  some  eunuchs  were  held  in  higli  esteem  by  the 
Roman  matrons  ;  it  possibly  could  have  been  some  of 
this  kind  of  a  eunuch  that  led  armies  or  ruled  in  the 
palaces.  Among  the  sultans  and  Oriental  potentates 
those  who  had  every  exterior  evidence  of  virility  re- 
moA'ed,  so  as  to  be  obliged  to  micturate  through  the 
means  of  a  catheter,  were  considered  the  safest  guards, 
as  well  as  they  were  the  highest-priced  eunuchs,  for  in 
their  manufacture  fully  75  per  cent,  of  those  operated 
upon  died  as  a  result.  It  is  related  that  the  Caribs 
made  eunuchs  of  their  prisoners  of  war  on  the  same 
principle  that  caponizing  is  resorted  to  for  our  kitchens, 
— the  prisoners  were  easier  to  fatten  and  were  more 
tender  when  cooked.  The  Italians  allowed  their  chil- 
dren to  be  eunuchized  for  chorister  purposes  in  church 
services,  their  soprano  voices  after  this  treatment  beino- 
simpl}^  perfect.  It  was  considered  that,  in  the  3'ear  prior 
to  the  papal  ordinance  of  Pope  Clement  XVI  forbidding 
the  practice  or  the  emplo^nnent  of  eunuchs  in  choirs, 
four  thousand  boj's,  mostly  in  the  neighborhood  of 
Rome,  were  castrated  for  chorister  purposes. 

In  China  eunuchs  were  in  use  during  the  reign  of 
the  Emperor  Yen-Wang,  in  781  B.C.  The  Chinese  make 
their  eunuchs  by  a  complete  ablation  of  all  genitals.  In 
India  the  followers  of  Brahma  never  placed  their  women 
in  charge  of  eunuchs.  In  Italj^  it  was  customary  to 
emasculate  boj^s  that  they  might  grow  up  with  the 
faculty  of  taking  the  female  parts  in  comedies,  their 
voices  thereby  assimilating  to  that  of  the  other  sex,  this 
being  on  the  same  principle  that  the  basso-profundos 
W2re  infibulated  that  they  might  retain  their  bass. 


92  History  of  Circumcision. 

Eunuchism  resulting  from  an  operation  owing  to 
disease  has  at  times  given  queer  and  unlooked-for 
results,  as,  for  instance,  in  the  case  of  the  old  man  that 
Sprengle  mentions,  in  whom  castration  did  not  remove 
an  inordinate  sexual  desire.  Sir  Astley  Cooper  men- 
tions a  case  in  his  "  Diseases  of  tlie  Testes  "  that  is 
somewhat  unique.  After  castration  Sir  Astley 's  patient 
showed  the  following  results :  "  For  nearly  the  first 
twelve  months  he  stated  that  he  had  emissions  in  coitu, 
or  that  he  had  the  sensations  of  emission ;  that  then 
he  had  erections  and  coitus  at  distant  intervals,  but 
without  the  sensation  of  emission.  After  two  years  he 
had  excretions  very  rarely  and  ver}'-  imperfectly,  and 
they  generally  ceased  immediately  upon  the  attempt  at 
coitus.  Ten  years  after  the  operation  he  said  he  had 
during  the  past  year  been  only  once  connected.  Twenty- 
eight  3'ears  after  the  operation  he  stated  that  for  years 
he  had  seldom  any  excretion,  and  then  that  it  was  im- 
perfect." In  regard  to  the  mortality  from  castration 
done  in  a  professionnl  manner  and  for  disease,  Curling, 
in  his  work  on  "  Diseases  of  the  Testis,"  observes  that 
he  saw  or  performed  some  thirty  operations  without  a 
death,  and  that  in  a  table  of  like  operations  performed 
at  the  Hotel  Dieu,  in  Paris,  it  appeared  that  the  mortal- 
ity was  one  in  four  and  a  quarter. 

J.  Royes  Bell,  in  the  sixth  volume  of  the  "  Inter- 
national Encyclopaedia  of  Surgery,"  has  the  following 
in  regard  to  the  practice  among  the  Mohammedans  in 
India:  "Young  boj^s  are  brought  from  their  parents, 
and  the  entire  genitals  are  removed  with  a  sharp  razor. 
The  bleeding  is  treated  b}^  the  application  of  herbs  and 
hot  ponltices;  haemorrhage  kills  half  the  victims,  and 
at  times  brings  the  perpetrators  of  the  vile  proceeding 
within  the  clutches  of  the  law." 


Emasculation^  Castration^  and  Eunuchism.  93 

The  ta.ille  a  fleur  de  ventre  of  the  Chinese  is  a  some- 
what primitive  procedure.  According  to  Dr.  Morache, 
in  his  account  of  China  in  the  "  Die.  Ency.  des  Sciences 
Medicates, "  tlie  operation  is  as  follows  :  "  The  patient, 
be  he  adult  or  child,  is,  previous  to  the  operation,  well 
fed  for  some  time.  He  is  then  put  in  a  hot  bath. 
Pressure  is  exercised  on  the  penis  and  testes,  in  order 
to  dull  sensibilit3^  The  two  organs  are  compressed  into 
one  packet,  the  whole  en.circled  with  a  silk  band,  regu- 
larly applied  from  the  extremit}^  to  the  base,  until  the 
parts  have  the  appearance  of  a  long  sausage.  The 
operator  now  takes  a  sharp  knife,  and  with  one  cut 
removes  the  organ  from  the  puljis  ;  an  assistant  immedi- 
ately applies  to  the  wound  a  handful  of  styptic  powder, 
composed  of  odoriferous  raisins,  alum,  and  dried  putt- 
ball  powder  (boletns-i)owder).  The  assistant  continues 
the  compression  till  haemorrhage  ceases,  adding  fresh 
supplies  of  the  astringent  powders  ;  a  bandage  is  added 
and  the  patient  left  to  himself.  Subsequent  haemorrhage 
rarely  occurs,  but  obliteration  of  the  canal  of  the 
urethra  is  to  be  dreaded.  If  at  the  end  of  the  third  or 
fourth  da}'^  the  patient  does  not  make  water,  his  life  is 
despaired  of.  In  children  the  operation  succeeds  in  two 
out  of  three  cases  ;  in  adults,  in  one-half  less.  Poverty 
is  the  cause  which  induces  adults  to  allow  themselves  to 
be  thus  mutilated.  It  is  said  to  be  difficult  to  distin- 
guish, these  last  from  ordinary  Chinese  men.  Adult- 
made  eunuchs  are  much  sought  after,  as  they  present 
all  the  attributes  of  virility  without  any  of  its  incon- 
venience." 

The  study  of  the  evolutionary  moves  or  processes 
passed  by  eunuchism  in  its  relation  to  music  and  the 
di'ama  tends  to  rob  these  otherwise  civilizing  and 
enlightened   arts  of  the   aureoles    of  poetry  and  gen- 


94  History  of  Circifincision. 

tility  with  which  the}''  have  been  surrounded.  From 
Bergmann  we  learn  that  the  practice  originated  in  tlie 
Orient,  where  female  voices  were  held  in  liigher  esteem 
in  singing,  and  where  the  profane  songs  that  accompa- 
nied the  dance  were  chanted  hj^  women.  The  Hebraic 
regulations  permitted  neither  women  nor  eunuchs  to 
sing  in  their  temples.  With  the  establishment  of  the 
earl}'  Christian  Churcli  in  Oriental  countries,  more  or 
less  of  tlie  ancient  Judaic  customs  were  retained,  and  in 
addition  a  too  literal  interpretation  of  the  words  of  St. 
Paul  was  adhered  to,  which  said  that  women  should  not 
be  heard  m  the  Church.  The  Oriental  Churcli  from  these 
reasons  long  remained  in  a  quandary  ;  according  to  the 
ceremonials,  it  was  deemed  requisite  to  imitate  as  near 
as  possible  the  voices  of  the  angelic  seraphims,  and  this 
could  not  be  done  by  the  rasping  bass  voices  of  the 
well-fed  monks  ;  women  were  out  of  the  question  in  the 
then  social  stage  of  church  evolution;  so  that  at  last  a 
compromise  was  effected  by  admitting  the  eunuch,  who 
could  chant  in  a  most  seraphic  soprano,  as  his  proto- 
type, the  mendicant  priests  of  Cybele,  had  done  before 
him. 

Constantinople  became  the  centre  of  learning  for 
Greek  music,  and  the  fine  soprano  solos  which  now  form 
the  attraction  of  many  of  our  modern  churches  were 
sung  by  the  eunuchs.  Eunuchs  were  not  onl}^  the  chief 
singers,  but  tlie}-  cultivated  the  art  into  a  science,  and 
Constantinople  furnislied  through  this  class  the  music- 
teachers  for  the  world,  as  we  learn  that  in  113Y  the 
eunuch  Manuel  and  two  other  singers  of  his  order  estab^ 
lished  a  school  of  music  and  singing  in  Smolensk, 
Russia.  There  is  no  doubt  but  that  in  a  moral  sense, 
considering  that  women  are  generall}^  the  pupils,  this 
was  a  most  meet  and  an  appropriate  arrangement ;  for, 


Emasculation,  Castration,  and  Eunuchism.         95 

as  St.  Alphonsns  M.  Liquori  observed,  rna,n  was  a  fool 
to  allow  his  daughters  or  female  wards  to  be  taught 
letters  b}'  a  inau,  eveu  if  that  man  were  a  saint,  and, 
as  real  saints  were  not  to  be  found  outside  of  heaven,  it 
can  well  be  imagined  how  much  more  dangerous  it  might 
be  to  liave  them  taught  music  and  singing  by  a  man  not 
a  eunuch, — elements  which  have  a  recognized  special 
aphrodisiac  virtue,  as  was  well  known  to  the  ancient 
Greeks,  who  onl^-  allowed  their  wives  to  listen  to  a 
certain  form  of  music  when  thej'  (the  husbands)  were 
absent  from  home. 

There  is  not  much  room  for  doubt  but  that  both 
morality  and  medicine  have  too  much  neglected  tlie 
study  and  contemplation  of  the  natural  history  of  ma:;, 
and  relied  altogether  too  much  on  the  efficacy  of  church 
regulations  and  castor-oil  and  rhubarb.  There  are 
other  things  to  be  done  l)esi(les  simply  framing  mor:il 
codes  and  pouring  down  mandrake  into  the  stomach  ; 
the  old  conjoined  service  of  priest  and  doctor  sliouhl 
never  have  been  discontinued,  as,  by  dividing  duties 
th:it  are  inseparable,  much  harm  has  resulted.  Herein 
dwelt  the  great  benefit  of  the  early  practice  of  medicine 
among  the  Greeks,  and  to  the  ph^ysical  understanding 
and  supervision  of  human  nature  by  the  Hebraic  law 
may  be  said  that  the  creed  owes  its  greatness  and  sta- 
bility, and  the  Hebrew  race  its  sturdy  stamina.  The 
wisdom  of  the  Mosaic  laws  is  something  that  always 
challenges  admiration,  the  secret  being  that  it  did  not 
separate  the  moral  from  the  physical  nature  of  man. 
Bain,  Maudsley,  Spencer,  Haeckle,  Buckle,  Draper,  and 
all  our  leading. sociologists  base  all  their  arguments  on 
the  intimate  relations  that  exist  between  the  ph3^sical 
surrounding  and  the  physical  condition  of  man  and  his 
moralit}'.     Churches  foolishly  ignore  all  this. 

4 


96  History  of  Circumcision. 

From  Constantinople  the  fiisliion  or  custom  gracliv 
ally  inA'aded  Italy  ;  and  as  Rome  was  the  centre  of  the 
new  religion,  so  it  also  became  the  centre  of  music,  and 
Rome  and  Naples  were  soon  the  home  of  the  eunuch 
devoted  or  immolated  to  the  science  of  music.  The 
eunuchs  reached  the  height  of  their  renown  in  music,  as 
well  as  what  might  be  termed  their  golden  era,  with  the 
establishment  of  the  Italian  opera,  in  the  seventeentli 
century.  At  this  period  all  the  stages  of  Italj-  were  the 
scenes  of  the  lyric  triumphs  of  this  otherwise  unfor- 
tunate class,  some  of  whom  accumulated  vast  fortunes. 
In  the  following  centurj^  as  has  been  seen,  Clement 
XVI  abolished  the  practice  as  far  as  the  church  Avas 
concerned,  and  in  the  present  century  the  first  Napo- 
leon abolished  the  practice  secularly  and  socially. 
Mankind  cannot  sufflcientl,y  appreciate  the  benefits  it 
received  from  the  results  of  the  French  Revolution  ;  we 
are  too  apt  to  look  at  that  event  simpl}'  from  the  un- 
avoidable means  which  an  uneducated  class — rendered 
desperate  by  long  suffering  and  brutalization  under  an 
organized  S3stem  of  oppressive  misrule — had  adopted 
to  remedy  existing  evils.  After  the  dissolution  of  tiie 
Directory  France  cannot  be  said  to  have  been  in  a  state 
of  anarch}',  and  the  long  and  bloody  wars  with  which 
Napoleon  is  usually  blamed  should  rather  be  charged  to 
that  government  and  imbecile  ministerial  polic}'  that 
lost  to  England  the  American  colonies.  The  series  of 
battles  from  Marengo  to  Waterloo  are  as  much  the 
creation  of  the  cabinet  of  George  III  as  those  from 
Concord  to  Yorktown.  AVaterloo  involved  more  than 
the  simple  defeat  of  Napoleon  ;  it  meant  the  defeat 
of  moral  and  intellectual  progress,  as  well  as  the  sup- 
pression of  the  rights  of  man.  The  suppression  of 
the  Inquisition  in  Spain,  and  of  eunuchism   in  Italj'^; 


Emasculation^  Castration^  and  Eunuchism.  97 

the  Code  Napoleon  ;  the  Imperial  highways  of  France; 
the  construction  of  its  harbors, — notably'  tliat  of  Havre  ; 
and  the  political  and  social  emancipation  of  the  Jews 
in  France,  Italj-,  and  German}^  are  monnments  to  tliis 
great  man  that  have  not  their  equals  to  crown  the 
acts  of  any  other  French  monarch.  Like  the  Phrygian 
monk  who  leaped  into  the  arena  in  Rome  to  sepnrate 
the  niaddened  gladiators,  and  who  was  stoned  to  death 
by  the  angry  and  brutal  mob  of  spectators  whose  amuse- 
ment he  stoi^ped,  Napoleon's  work  has  had  its  results,  in 
spite  of  Waterloo  and  St.  Helena.  The  mart3'rdom  of 
the  poor  monk  caused  an  abolishment  of  the  brutal 
sports  of  the  Colosseum,  which  henceforth  crumbled  to 
pieces.  Little  did  the  peo[)le  look  for  this  result  who 
trampled  the  monk  under  foot.  Neither  did  Blucher, 
debouching  on  the  English  left  with  Bnlow's  battalions 
on  the  evening  of  Waterloo,  foresee,  some  fifty  years 
hiter,  Prussia  extending  its  hand  to  make  a  united  Italy, 
wliich  wMth  Napoleon — who  was  by  blood,  nature, 
instinct,  and  education  an  Italian — had  been  the  dream 
and  ambition  of  his  life. 

Eunuchism  as  a  punishment  is  an  old  practice,  as 
the  ancient  Egyptians  inflicted  it  at  times  upon  their 
prisoners  of  war ;  so  it  formed  part  of  their  i)enal  code, 
and  we  are  told  tliat  rape  was  punished  by  the  loss  of 
the  virile  organ  ;  a  like  punisliment  for  the  same  offense 
was  in  vogue  with  the  S|)aniards  and  Britons  ;  with  the 
Romans  at  different  times  and  with  the  Poles  the 
punishment  was  castration.  The  difficult}^  of  proving 
the  crime,  as  well  as  the  ease  with  whicii  the  crime 
could  be  charged  throngli  motives  of  revenge,  spite,  or 
cupiclitj'on  innocent  persons,  should  never  have  allowed 
this  form  of  punishment  to  be  so  generally  used  as  his- 
tory relates  that  it  was ;    rape  being  one  of  the  most 


98  History  of  Circumcision. 

complex  and  intricate  of  medico-legal  subjects,  unless  we 
take  M.  Voltaire's  summarj'  and  Solomonic  judgment, 
who  relates  that  a  queen,  who  did  not  wish  to  listen  to  a 
charge  of  rape  made  hj  one  person  against  another,  took 
the  scabbard  of  a  sword  rtnd,  while  she  kept  the  open 
end  in  motion,  asked  the  accuser  to  sheath  the  sword. 

Count  Raoul  Du  Bisson,  Dedjaz  de  VAbyssinie,  gives 
some  A'er}^  interesting  information  in  regard  to  eunuch- 
ism in  his  work  entitled  "  The  Women,  the  Eiuiuchs, 
and  the  Warriors  of  the  Soudan."  Count  Bisson  has 
looked  on  the  question  from  its  moral,  physical,  and 
demographic  stand-points,  and,  having  seen  eunuchism 
in  its  different  as[)ects,  from  his  landing  at  Alexandria 
and  Cairo,  down  through  his  different  expeditions  into 
Arabia,  the  Soudan,  and  Abyssinia,  his  observation^  are 
well  worth  repeating. 

From  a  demographic  and  statistical  view  of  the  sub- 
ject, its  truly  Malthusian  results  become  at  once  shock- 
ingly and  persistently  prominent, — not  alone  in  the 
interference  that  the  condition  induces  in  arresting  any- 
further  procreation  on  the  part  of  the  unfortunate  vic- 
tim, but  in  the  unparalleled  mortality  that,  in  the  gross, 
is  made  necessar}'  by  the  results  of  the  operative  pro- 
cedures. The  Soudan  alone  furnished, according  to  reli- 
able statistics,  some  3800  eunuchs  annually,  the  material 
coming  from  Ab^-ssinia  and  the  neighboring  countries, 
it  being  gathered  by  war  and  kidnapping  parties,  or  by 
purchase,  from  among  tiie  young  male  population  of 
those  regions.  These  children  are  brought  to  the  Sou- 
dan frontier  and  custom  duties  are  there  paid  for  their 
passage  across  the  border,  the  duty  being  about  two 
dollars  per  head.  At  Karthoum  the}'  are  purchased  by 
pharmacists,  apothecaries,  and  others  engaged  in  thj 
manufacture  of  eunuchs,  who  generall}'  perform  simple 


Uniasculation,  Cadratioii.,  and  Ebnuchiam.         99 

castration  ;  the  mortality  among  these  amounts  to  about 
33  per  cent.  These  simi)ly  castrated  eunuchs  bring 
about  $200  apiece.  Tlie  great  eunuch  factor3'  of  the 
country,  however,  is  to  be  found  on  Mount  Ghebel-Eter, 
at  Abou-Gerghe  ;  liere  a  large  Coptic  monaster}^  exists, 
where  the  unlbrtunate  little  African  children  are 
gathered.  Tlie  building  is  a  large,  square  structure, 
]-esembling  an  ancient  fortress  ;  on  the  ground-floor  the 
operating-room  is  situated,  with  all  the  ap[)liances 
required  to  perform  these  horrible  operntions.  The 
Coptic  monks  do  a  thriving  business,  and  furnish  Con- 
stantinople, Arabia,  and  Asia  Minor  with  manj'  of  their 
complete,  mueh-sought-for,  and  expensive  eunuchs. 
They  here  manufacture  both  grades, — those  who  are 
simpl}^  castrated  and  those  on  whom  complete  ablation 
of  all  organs  has  been  performed,  the  latter  bringing 
from  $750  to  $1000  per  head,  as  only  the  most  robust 
are  taken  for  this  operation,  which  nevertheless,  even 
at  the  monastery,  has  a  mortalit}'  of  90  per  cent. 

The  manner  of  performing  the  operation  is  as  bar- 
barous and  revolting  as  the  nature  of  the  operation 
itself,  and  the  cruel  and  ignorant  after-treatment  is  as 
full^'  in  keeping  with  the  whole.  The  little,  helpless, 
and  unfortunate  prisoner  or  slave  is  stretched  out  on 
an  operating-table;  his  neck  is  made  fast  in  a  collar 
ftxstened  to  the  table,  and  his  legs  spread  apart  and  the 
ankles  made  fast  to  iron  rings;  his  arms  are  each  held 
by  an  assistant.  The  operator  then  siezes  the  little 
penis  and  scrotum  and  with  one  sweep  of  a  sharp  razor 
removes  all  the  appendages.  The  resulting  wound 
necessarily  bares  the  pubic  bones  and  leaves  a  large, 
gaping  sore  that  does  not  heal  kindly-.  A  short  bamboo 
cannula  or  catheter  is  then  introduced  into  the  ui-ethra, 
from  which  it  is  allowed  to  project  for  about  two  inches, 


]  00  History  of  Circumcision. 

and  no  tittention  is  paid  to  any  arterial  haemorrhage ; 
the  wliole  wound  is  simply  plastered  up  with  some 
haemostatic  compound  and  the  little  victim  is  then 
buried  in  the  warm  sand  up  to  his  neck,  being  exposed 
to  the  hot,  scorching  rays  of  the  sun  ;  the  sand  and  soil 
is  tightly  packed  about  his  little  bod}^  so  as  -t©  prevent 
any  possibility  of  any  movement  on  the  part  of  the 
child,  perfect  immobility  being  considered  hy  the 
monks  as  the  main  element  required  to  promote  a  suc- 
cessful result.  It  is  estimated  that  35,000  little  Africans 
are  annually  sacrificed  to  produce  the  Soudanese  average 
quota  of  its  3800  eunuchs. 

When  this  immense  sacrifice  of  life,  the  useless 
barbarity,  and  the  really  unnecessary  needs  of  such 
mutilated  humanity  existing  are  full}^  considered,  it 
would  seem  as  if  Christian  nations  might,  with  some 
reason,  interfere  in  this  horrible  traffic,  by  the  side  of 
which  ordinary  slavery  seems  but  a  trifle.  When  we 
further  consider  that,  in  some  instances,  the  child 
is  also  made  mute  by  the  excision  of  part  of  the 
tongue, — as  mute  or  dumb  eunuchs  are  less  apt  to  enter 
into  intrigues,  and  are  therefore  higher  prized, — the 
barbarity',  cruelt}^,  and  extremes  of  inhumanity  that 
these  poor  children  have  to  suffer  cannot  be  over- 
estimated. Neitlier  must  Ave  be  astonished  at  the  stolid 
indifference  that  is  exhibited  b3' the  eunuchs  in  after  life 
to  any  or  all  sentiments  of  humanity,  or  that  they  should 
hold  the  rest  of  humanity  in  continual  execration. 

Often-occurring  accidents  in  harems  make  complete 
eunuchs  a  desideratum.  Bisson  mentions  that  on  one 
occasion  he  saw  the  chief  eunuch  of  the  Grand  Cherif 
of  Mecca — a  large,  finely-proportioned,  powerful  black — 
on  his  wa}^  to  Stamboul  for  trial  and  sentence  ;  he  was 
heavily  chained  and  well  guarded.     It  appears  that  the 


Emasculation,  Castration,  and  Eunuchism.       101 

eunuch  had  only  been  partl}'^  castrated,  and  that  the 
operation  had  been  performed  during  infancy;  his  tes- 
ticles had  not  fully  descended,  so  that  in  the  operation 
the  sac  was  simply  obliterated,  which  gave  him  the 
a[)pearance  of  a  eunuch.  In  this  condition  he  seemed 
to  have  kept  a  perfect  control  of  himself  and  passions 
until  made  chief  eunuch  of  the  Cherif,  who  possessed  a 
well-assorted  harem  of  choice  Circassian,  Georgian,  and 
European  beauties.  The  neglige  toilet  of  the  harem 
bath  and  the  seductive  influence  of  this  terrestrial 
Koranic  seventh  heaven  was  too  much  for  the  warm 
Soudanese  blood  of  the  chief;  his  forays  were  not  sus- 
pected until  a  blonde  Circassian  houri  presented  her 
lord  and  master,  the  Cherif,  with  a  suspiciously  mulatto- 
looking  son  and  heir.  A  consultation  of  the  Koran 
failed  to  explain  this  discrepanc3',  and  suspicion  pointed 
to  the  chief  eunuch,  who  was  accordingly  watched  ;  it 
was  found  that  he  had  not  only  corrupted  the  fair  Cir- 
cassian, but  every  inmate  of  the  harem  as  well.  The 
harem  was  promptly  sacked  and  drowned  and  the  false 
eunuch  shipped  to  the  Sultan  for  sentence,  the  Cherif 
having  the  right  to  sentence  and  drown  the  harem,  but 
having  no  such  rights  over  such  a  high  personage  as  the 
chief  eunuch. 

There  are  physiological  facts  and  pathological  con- 
ditions brought  forth  for  our  contemplation,  while  inves- 
tigating the  subject  of  eunuchism  in  all  its  details,  that 
cause  us  to  feel  that,  after  all,  the  old  Hippocratic 
principle  of  inductive  philosoph}^  upon  which  our  study 
and  practice  of  medicine  is  founded,  with  rational 
experience  and  observation  for  its  corner-stone,  is,  even 
if  commonplace,  the  only  proper  avenue  of  knowledge. 
To  exemplify  this  proposition  we  have  in  this  particu- 
lar subject  the  practical  observations  and  experience  of 


102  History  of  Circumcision. 

M.  Moiulat,  of  Moutpellier ;  in  his  interesting  work  on 
''  De  la  Sterilite  rle  I'Homnie  et  de  la,  Femine,"  published 
in  1840,  he  details  some  instructive  information  on  the 
subject  of  eunuchs,  giving  some  explanation  as  to  wh}^ 
many  simply  castrated  eunuchs  are,  like  the  much-prized 
eunuchs  of  the  Roman  matrons,  still  able  to  acquit 
themselves  of  the  copulative  function.  He  mentions 
that  while  in  Turkey  he  studied  the  subject  in  its  de- 
tails, and,  having  found  some  of  these  copulating 
eiuiuchs,  he  secured  some  of  the  ejaculated  fluid  and 
subjected  it  to  a  careful  examination.  The  discharge 
was  lacking  the  characteristic  seminal  odor  ;  it  was  in 
other  respects,  to  the  palpation  especially,  very  much 
like  the  seminal  fluid.  He  found  that  these  eunuchs 
were  much  given  to  venereal  enjoyment,  but  that  either 
legitimate  intercourse  or  masturbation,  to  which  many 
were  addicted,  was  apt  to  be  followed  by  a  marasmus 
ending  in  galloping  consumption.  Mondat  personally 
knew  the  opera-singer  Yelutti,  who  died  in  London  ; 
Velutti  W'as,  when  a  child,  castrated  by  his  parents, 
having  both  testicles  removed,  being  intended  by  his 
father,  who  had  himself  performed  the  operation,  for 
the  choir  of  the  Papal  Chapel  at  Rome.  Velutti  Avas 
as  much  of  a  favorite  in  his  day  as  our  present 
tenors  and  handsome  actors.  The  admiration  of  the 
opposite  sex  was  fatal  to  him  ;  he  formed  a  liaison  with 
a  young  English  lady  residing  in  London,  and  the  re- 
sulting excesses  in  which  he  indulged  quickly  brouglit 
him  to  his  grave.  He  was  passionately  fond  of  women 
and  was  able  to  acquit  himself  perfectl^^ ;  at  least,  as 
far  as  the  copulative  act — barring  fecundation — was 
concerned. 

Li  a  preA'ious  part  of  this  chapter  I  have  alluded 
to  the   very   appropriate   arrangement  which   formerly 


Emasculation^  Ca.slration,  and  Eunuchism.        103 

existed  ■u'lieii  niusic-teacLers  were  eunuchs,  and  that 
our  higher  circles  of  societ\^  wouhl  do  Avell  to  employ 
euiiuchized  coaclnneu,  especially  if  possessed  of  suscep- 
tible and  elopahle  daughters  ;  but,  from  the  accounts 
giveu  by  Mondat,  it  would  seem  that  they  are  not  as 
safe  as  might  at  first  be  imagined.  However,  they  could 
not  be  as  dangerous  as  the  chief  eunuch  of  the  Grand 
Cherif  of  Mecca  and  increase  the  population  to  the  same 
extent;  but  I  should  judge  that  they  might  be  a  ver^' 
demoralizing  moral  element  if  introduced  into  modern 
society.  If  eunuchs  must  be  emplo3'ed,  it  can  easilj^  be 
understood  why  the  Turk  and  Chinese  prefer  the  real, 
clean-cut  article.  The  New  York  "Four  Hundred" 
should  make  a  note  of  this,  as  in  their  present  thirst 
for  European  aristocratic  notions,  coats  of  arms  and 
titles,  there  is  no  telling  how  soon  they  may  cross  over 
into  Oriental  customs  and  run  a  hareni,  in  which  case  it 
would  be  sad  to  have  them  make  an}'  mistakes  in  the 
quality  and  ability  of  the  eunuch. 

Dr.  Gardner  W.  Allen  has  furnished  the  American  pro- 
fession with  a  faithful  translation  of  the  vnluable  work 
of  Professor  Ultzniann  on  '•  Sterility  and  Impotence.'' 
In  this,  we  h:i,ve  a  clear  and  intelligent  dissertation  that 
explains  the  above  conditions,  and  I  am  only  surprised 
that  the  observations  of  Mondat  have  not  develop/ed 
such  explanations  before,  as  the  principle  was  fully 
explained  in  practice  fifty  years  ago  by  the  Montpellier 
physician.  According  to  Ultzmann,  there  is  a  form  of 
fecundating  impotence  in  persons  otherwise  well  pro- 
vided with  an  apparent  complete  apparatus,  an  impo- 
tence which  he  terms  potentia  generandi.  He  states, 
however,  that  this  form  of  impotence  was  not  recognized 
until  a  few  years  ago,  citing  the  fact  that  females  have 
had,  as  a  rule,  to  bear  all  of  the  blame  for  the  unfruit- 


104  History  of  Circumcision. 

fulness  of  the  familj',  and  tliat  the}'  have  been  accord- 
ingl}'  subjected  to  all  manner  of  operations,  general  and 
local  treatment,  even  to  being  sent  to  watering  places 
and  sanatoria  where  red  headed  male  attendants  are 
emplo3'ed,  to  sa}-  nothing  of  the  pra3ers,  intercessions, 
pilgrimages,  and  novenas  to  the  holy  shrines,  as  men- 
tioned in  the  chapter  on  the  holy  prepuce.  Ultzmann 
observes  that  a  man  may  be  perfeetlj'  able  to  go  through 
the  procreative  or,  rather,  the  copulative  act,  even  to  the 
great  satisfaction  of  all  parties  concerned,  and  yet  be 
perfectl}^  impotent ;  he  even  goes  further,  by  observing 
tliat  there  are  cases  in  which  copulation  maj^  take  place 
without  an}^  fluid  whatever  being  ejaculated.  He  men- 
tions two  such  cases  at  pages  87  and  116  of  his  book. 
In  the  first  instance  the  ejaculated  fluid  is  precisely  as 
that  observed  in  such  cases  as  those  of  the  eunuchs  and 
of  Yelutti,  mentioned  hy  Mondat,  and  consisted  of  an 
azoospermia  discharge,  made  up  mainly  from"  the  secre- 
tion of  the  seminal  vesicles,  the  accessory  glands  of  the 
urethra,  the  prostate,  and  Cowper's  glands,  as  well  as  the 
discharge  from  the  secretor}^  glands  distributed  along 
the  course  of  the  urethral  mucous  membrane.  Some  of 
the  cases  of  this  form  of  impotence  have  exhibited  won- 
derful copulating  desire  and  power  of  endurance,  and, 
even  if  unfecundating,  they  must  be  said  to  be  better 
off  than  the  victims  of  that  other  form  of  male  impo- 
tence, the  poteyitia  coeiindi  of  Ultzmann,  where,  with  a 
normal  semen,  either  the  power  of  erection  or  that  of 
ejaculation  may  be  entirely  absent. 


CHAPTER  IX. 

Philosophical  Considerations  Relating  to  Eunuchism 
AND  Medicine. 

Eunuchism  does  not  alwa3's  siilKlue  the  animal  pns- 
sioiis  ;  this  is  the  view  that  the  church  took  in  connec- 
tion with  the  eniasciihition  of  Origenes  and  his  monks; 
the  church  here  heUl  that  not  onlj-  was  it  possible 
for  them  to  still  sin  in  heart  or  imagination,  but  that, 
even  were  the  complete  eradication  of  the  sexual  idea 
possible,  they  had  b^'  their  act  lost  the  main  glory 
of  a  Christian, — that  of  successfully  striving  against 
temptation,  and  by  a  force  born  of  triumphant  virtue 
overcome  all  the  wiles  of  the  devil.  It  is  related  that 
among  the  eunuchs  at  Rome  tliere  were  some  who, 
having  been  made  so  Inte  in  life,  still  retained  the  power 
of  copulatiou,  although  the  final  act  of  the  performance 
was  absent.  Montfalcon  relates  that  Cabral  rei)orted 
dissecting  a  soldier  who  was  hanged  for  committing  a 
rape,  but  who  on  dissection  showed  not  the  least  trace 
of  testicles,  either  in  the  scrotum  or  abdomen,  although 
the  seminal  vesicles  were  filled  with  some  flu  id. ^*  Spren- 
gle,  in  his  ''  History  of  Medicine,"  relates  of  the  complete 
removal  of  both  testicles  from  an  old  man  of  seventy 
years  of  age,  on  account  of  inordinate  sexual  desire,  the 
operation  having  no  perceptible  effect  in  subduing  the 
disease. ^^  These  cases  are  analogous  to  those  exception- 
able cases  in  which,  after  extirpation  of  the  ovaries, 
both  menstruation  and  fecundation  have  still  taken 
place. 

Modern  civilization  and  its  unnatural  mode  of  dress- 
ing inflict  great  harm  on  men  by  keeping  these  parts 

(105) 


106  History  of  Circumcision. 

too  warm  and  constricted.  Much  of  the  irritability  of 
tliese  organs,  as  well  as  their  decadence  at  an  age  some 
generation  or  two  before  the  time  when  they  should 
still  possess  all  their  virile  attributes,  can  be  directly 
attributed  to  this  cause.  A  more  intelligent  wa}-  of 
dressing  would  result  in  less  moral  and  physical  wreck- 
age, and  require  less  galvanic  belts  and  aphrodisiacs  in 
men  under  fift3\  If  those  who  habitually  swath  their 
scrotums  in  the  heavy  folds  of  their  flannel  shirts,  to 
which  are  superadded  the  cotton  shirts,  drawers,  and 
outer  clothes  in  which  civilized  man  incases  himself, 
would  cast  a  backward  eye  into  the  dim  and  mist}^  past, 
and  see  the  priest  of  some  of  the  old  Pagan  gods  soak- 
ing the  scrotum  in  hot  water,  and  then  graduall}-  rub- 
bing the  testicles  within,  by  gentle  but  firm  friction, 
to  make  the  testicles  disajopear ^  a  process  by  which  many 
of  the  heathen  priests  prepared  themselves  for  the  dis- 
charge of  their  sacerdotal  duties  and  the  strict  observ- 
ance of  those  rules  of  chastit3'^  and  celibacy  which  they 
were  henceforth  to  live  up  to,  they  would  find  one  ex- 
planation of  why  civilized  man  does  not  possess  that 
vigor  and  retain  that  proereative  power  into  advanced 
age  that  was  one  of  the  ciiaracteristics  of  our  ancient 
progenitors  in  the  days 'that  breeches  were  as  abbre- 
viated as  those  now  worn  by  the  Sioux  Indians.  These 
are  reality  but  leggins,  which  run  onh^  to  the  perineum 
and  are  simply  tied  by  outer  points  to  a  strap  from  each 
hip.  Finely  and  comfortabl\'  cushioned  chairs  ma}^  be 
a  luxury  to  sit  on,  but  the}'  will  have,  on  the  man  Avho 
uses  them  in  youth  and  in  his  prime,  a  wonderful  seda- 
tive and  moral  influence  later  on,  about  as  effectual  as 
the  miniature  warm  baths  for  the  scrotum  and  gentle 
pressure  to  the  testicles  that  were  used  by  the  heathen 
priests  of  old,  who  preferred  a  gradual  disappearance  of 


Considerations  of  Eunuchism  and  Medicine.       107 

the  glands  to  the  too  sadden  and  summary  methods  of 
tlie  Cjbelian  clergy,  who  used  a,  piece  of  shell  and  an 
elaboratelj' -performed  castration.  According  to  Paulas 
-^gineta,  this  was  a  common  practice  of  making  ennuchs 
out  of  3'oang  boys  in  the  Orient,  tlie  mortalit}-  being 
hardl}^  anj- ;  whereas  tlie  taille  a  fiear  de  ventre,  the 
favorite  method  for  making  eunuchs  for  harem  guards 
and  attendants,  and  more  suited  to  the  jealous  disposi- 
tion of  the  Turk,  has  a  mortality  of  three  out  of  every 
four,  according  to  Cliardin, and  of  two  out  of  evei'y  three, 
according  to  Clot  Bey,  the  chief  physician  of  the  Pasha,^® 
and  of  nine  out  of  ten,  according  to  Bisson.  So  prone 
to  reach  high  offices  were  intelligent  eunuchs  that  it  is 
related  that  parents  were  at  times  induced  to  treat  their 
bo3's  in  the  manner  above  stated,  that  they  might  be  on 
the  highwaj^  to  royal  favor,  honor,  and  rank ;  such  is 
the  ennobling  tendency'  of  Oriental  despotism,  polyg- 
amy, and  harem  life.  On  the  same  principle  Europeans 
subjected  their  boys  to  a  like  operation  to  fit  them  for  a 
chorister  life  or  the  stage,  where  fame  and  honor  and 
wealth  were  to  be  found. 

Medicine  has  been  the  butt  of  wits  and  philosophers, 
as  well  as  of  the  men  wlio,  from  the  profession,  have 
gone  into  the  ranks  of  literature.  Smollet,  himself  a 
physician,  gives  us  an  insight  into  our  wandering  and 
erratic  misapplication  of  our  knowledge  on  therapeutics 
in  "  Peregrine  Pickle,"  where  the  poor  painter.  Pallet, 
is  believed  to  be  a  victim  of  hydrophobia.  The  learned 
opinion  of  the  doctor,  wlio  explains  the  many  and  va- 
rious reasons  by  which  he  arrives  at  his  diagnosis,  the 
A^avious  phj'sical  signs  exhibited  by  the  patient  as  being 
pathognomonic  of  the  disease,  and  his  final  venture  with 
the  contents  of  the  pot  de  chambre,  as  a  diagnosis  veri- 
fier, which  he  dashes  in  the  patient's  face  in  preference 


108  History  of  Circumcision. 

to  ordinaiy  water  on  account  of  the  medicinal  virtues 
contained  in  urine,  wliich  in  the  case  seemed  to  him  to 
have  a  peculiar  therapeutic  value,  is  something  worth 
reading,  however  ludicrous  it  all  sounds.  There  are 
few  intelligent  physicians  but  who  liave  seen  as  ridicu- 
lous performances,  in  wh:it  might  be  called  medical 
g_ymnasts,  that  equal,  if  not  surpass,  those  of  Smollet's 
doctor.  Rabelais  was  also  a  professiouMl  brother,  who, 
equally  with  SmoUet,  attempted  to  waken  up  the  i)ro- 
fession  by  his  satires.  Smollet  was  not  onlj'  a  physician, 
but  in  his  early  life  had  seen  some  very  active  and  prac- 
tical work,  having  participated  in  and  been  a  witness  tc 
the  ills  and  misfortunes  that  follow  any  attempts  to 
"  lock  horns  "  with  nature  througii  ignorance  of  ph\'sical 
laws  and  preventive  medicine,— having  been  a  surgeon's 
mate  in  the  fleet  which  assisted  the  land  forces  in  the 
murderous  and  ill-fated  Carthagena  expedition  which 
cost  England  so  many  lives,  ignorantly  and  needlessly 
sacrificed  to  ministerial  disregard  of  physical  laws  and 
its  consequences, — lessons  which,  unfoitunately,  seem  to 
have  but  little  effect  on  cabinets,  owing  to  their  shifting 
personelle^  England  following  up  the  disasters  of  Car- 
thagena with  the  still  greater  blunder  of  the  Walcheren 
expedition,  where,  out  of  England's  small  available 
])hvsical  war  material,  nearly  forty  thousand  men  were 
either  left  to  fatten  the  swamps  of  Walcheren,  or  to 
wander  thi-ough  England  in  after  j'ears  on  the  pension- 
list,  physical  wrecks  and  in  bodily  and  financial  miser3^27 
Again,  the  same  disregard,  born  of  ignorance  and  red 
tnpe,  crippled  the  British  army  in  the  Crimea,  causing 
in  its  ranks  the  greatest  mortality'.  It  has  seemed  as 
if  it  would  be  of  advantage  if  all  the  blunders,  either 
philosophical  or  of  statesmanship,  committed  by  a  cabi- 
net, should  be  written  in  large  letters  of  gold,  to  be  hung 


Considerations  of  Eunuchism  and  Bfedicine.       109 

in  tlie  coiincil-lialls  of  the   nations,  that   similar  blun- 
ders at  least  might  not  occur  again. 

Dumas,  in  his  "  History  of  the  Two  Centuries"  and 
his  "  History  of  the  Century  of  Louis  the  XIV,"  gives 
some  very  interesting  medical  touches.  Le  Sage,  in  his 
"Adventures  of  Gil  Bias,"  gives  us  food  for  speculating 
on  medical  philosoph}'  in  connection  with  the  interesting 
subject  of  how  to  make  the  profession  remunerative. 
Dickens's  ideas  of  the  doctor,  as  given  in  his  works,  are 
life  touches.  Witness  his  description  of  the  little  doctor 
who  superintended  little  David  Copperfield's  advent  into 
the  world,  or  of  Dr.  Slammer  of  the  army;  they  repre- 
sent his  view  of  the  professional  character.  Fontenelle, 
probably,  was  right  in  ascribing  the  fact  of  his  becoming 
a  centenarian,  and  maintaining  a  stomach  with  the  force 
and  resistance  that  are  the  peculiar  characteristics  and 
attributes  of  a  chemical  retort,  to  the  fact  that  when  sick 
it  was  his  practice  to  throw  the  doctor's  physic  out  of 
the  window  as  the  doctor  went  out  of  the  door,  as  in  his 
day  a  man  required  the  constitution  of  a  rhinoceros  and 
the  stomach  of  an  ostrich,  with  the  external  insensibility 
of  a  crocodile,  to  withstand  the  ordinary  doctor  of  the 
period  and  his  medications.  Napoleon  believed  that 
Baron  Larrey  was  the  most  virtuous,  intelligent,  useful, 
and  unselfish  man  in  existence  ;  in  fact,  it  is  doubtful  if 
any  man  of  his  time  commanded  from  this  trul}'  great 
man  so  much  admiration  or  respect,  either  for  bravery, 
courage,  intelligence,  or  activity,  as  the  great  and  simple- 
minded  ho-vvey.  As  observed  by  Napoleon  of  his  bravest 
general, — poor  Marshal  Ney,  the  bravest  of  the  brave, 
the  rear  guard  of  the  grand  armv,  the  last  man  to  leave 
Russian  soil, — Ney  was  a  lion  in  action,  but  a  fool  in 
the  closet.  All  his  generals  had  some  great  distinguish- 
ing characteristic,  beyond  which  was  a  barren  waste,  a 


110  Hidory  of  Circumciaion. 

A'acuity,  but  too  apparent  to  a  man  of  Napoleon's  dis- 
eernnient.  But  the  cool,  unflinching  bravery  of  Larrey, 
that  (lid  not  require  the  stimulus  of  the  fight  or  the 
phrenzy  of  strife  to  bring  it  to  tlie  surface  and  keep  it 
alive ;  bravery  and  intelligence  alike  active  under 
showers  of  sliot  and  shell  or  in  the  thunders  of  cliMrg- 
ing  squadrons  :  in  the  face  of  infective  epidemics  or  con- 
tagiousness, walking  about  in  these  scenes  in  which  his 
own  life  was  as  much  at  stake  as  that  of  the  meanest 
soldier,  with  tlie  same  cool  exercise  of  his  intelligence 
that  he  exhibited  in  the  organization  and  superintend- 
ence of  his  hospitals  in  the  time  of  peace ;  always  the 
same,  untiring,  unnuirmuring,  brave,  studious,  observing, 
unflinching  in  his  duties,  unselfish;  whether  in  the  burn- 
ing sands  of  Egypt  or  in  the  snowy  steppes  of  Russia, 
in  the  marshy  plains  of  Italy  or  in  the  highlands  of 
S[)ain,  he  always  found  him  the  same,  and  his  notes  and 
observations,  from  his  first  government  service  on 
the  Newfoundland  coast  to  his  last,  always  showed 
him  the  same  hiborer  and  student  in  the  field  of  medi- 
cine. And  yet  at  St.  Helena  we  find  Napoleon  refusing 
to  take  remedies  for  internal  disease  whose  real  nature 
was  unknown,  and  onl^'  toward  the  end  did  he  consent 
to  take  anything,  and  then  only  when  seeing  that  the 
end  was  approaching,  and  more  from  a  kindly  desire  to 
express  his  jipi)reciation  of  the  services  of  his  attend- 
ants, and  not  to  wound  tlieir  feelings,  than  from  nny 
hope  of  assistance.  Napoleo)i  had  not  neglected  tlie 
studj^  of  me<licine  any  more  than  he  had  the  study  of 
every  other  science.  This  is  evident  from  the  instance  re- 
l;ited  as  takino^-  place  during  the  march  of  the  grnnd  army 
from  the  confines  of  Poland  into  Russia,  in  1812,  when 
dysentery  became  A^ery  prevalent,  of  his  inviting  several 
of  his  favorite  guard  to  his  own  table,  where  he  experi- 


Considerations  of  Eunuchism  and  Medicine.       Ill 

mented  on  each  particular  grenadier  witli  a  specific  form 
of  diet,  so  as  to  determine  its  cause  and  possible  rem- 
edy. He  did  not  look  upon  our  knowledge  of  pathology 
and  our  skill  in  diagnosis  as  being  sufficiently  advanced  or 
perfect  to  make  him  feel  but  that  a  treatment  for  an  ob- 
scure disease  like  his  own  would  be  pretty  much  a  matter 
of  guess-work.  Charles  Reade,  in  his  "  Man  and  Wife," 
shows  an  intimate  knowledge  of  medical  science  where  he 
philosophizes  on  the  effects  of  an  irregular  life  and  of  over- 
ph}- sical  training.  His  logic  is  sound  science.  Defoe  and 
Cervantes  show  a  like  intelligent  insight  as  to  medicine; 
and  it  was  not  without  reason  tliat^3'denham,  the  Eng- 
lish Hippocrates,  advised  a  student  of  medicine  who  en- 
tered his  office  as  a  student  to  begin  the  study  of  medi- 
cine by  the  careful  study  of  "  Don  Quixote,"  remarking 
that  he  found  it  a  work  of  great  value,  which  he  still 
often  read.  The  works  of  Bacon  and  of  Adam  Smitli 
on  "Moral  Sentiments;"  the  famous  treatise  on  the 
"  Natural  History  of  Man,"  by  the  Rev.  John  Adams; 
the  later  works  of  Buckle,  Spencer,  Darwin,  Draper, 
Leck,y,  and  other  robust  wielders  of  the  Anglo-Saxon 
pen,  as  well  as  the  works  of  Montaigne,  Montesquieu, 
La  Fontaine,  and  Yoltaire,  are  all  works  that  the  medical 
man  could  probably  read  with  more  profit  than  loss  of 
time.  In  fact,  either  Hume,  Macaulay,  or  any  philo- 
sophical work  on  history  will  furnish  to  the  physician 
additional  knowledge  of  use.in  his  profession.  No  phy- 
sician can  afford  to  neglect  any  study  that  in  any  man- 
ner adds  to  his  knowledge  of  the  natural  history  of  man, 
as  therein  is  to  be  found  the  foundation  of  our  knowledge 
as  to  what  constitutes  health,  and  as  to  what  are  the 
causes  that  lead  humanity  to  diverge  from  the  paths  of 
health  into  those  of  physical  degeneracy  and  mental 
and  bodily  disease. 


112  History  of  Circumcision. 

We  have  in  medicine  many  sayings  which  pass  for 
truisms,  which  are,  after  all,  misleading.  We  say,  for 
instance,  keep  the  feet  warm  and  the  head  cool ;  this 
will  not  always  either  keep  you  comfortable  or  well,  as 
we  know  that  in  neuralgias  it  is  absolutely  necessary, 
either  for  comfort  or  to  get  well,  to  keep  the  head  warm. 
While  so  much  stress  is  laid  on  the  necessity  of  keeping 
the  head  cool,  a  thing  a  person  is  sure  to  look  after 
whenever  the  head  becomes  uncomfortably  warm,  and 
to  which  can  be  ascribed  but  few  ailments  or  deaths,  we 
hear  comparatively  ^nothing  about  the  thermometric 
condition  of  the  perineum,  which,  from  the  varying 
temperatures  in  which  it  is  at  times  plunged,  produces 
more  beginnings  for  diseases  in  the  future,  during 
3^outh  and  our  prime,  as  well  as  it  quite  often  causes 
the  sudden  ending  of  life  in  more  advanced  periods. 
People  who  carefully  observe  the  rule  of  keeping  their 
heads  cool  and  their  feet  warm  will  stand  with  out- 
spread legs  and  uplifted  coat-tails  with  their  backs  to  a 
blazing  grate,  and  then,'  going  outside,  incontinently  sit 
down  on  a  stone  or  iron  door-step,  or,  stepping  into  a 
carriage  or  other  vehicle,  they  sit  down  on  a  cold  oil-cloth 
or  leather  cushion,  without  the  least  knowledge  of  the 
harm  or  danger  that  they  are  liable  to  incur.  They  little 
dream  of  the  prostatic  troubles  that  lie  in  wait  for  the 
imwaiy  sitter  on  cold  places,  ready  to  pounce  upon  him 
like  the  treacherous  Indian  lying  in  ambush, — ti-oubles 
that  carry  in  their  train  all  the  battalions  of  urethral, 
bladder,  kidne\^  disease  and  derangments,  and  subsequent 
blood  disorganization,  which  often  begin  in  a  chilled 
perineum,  and,  in  conjunction  with  the  local  disease 
that  ma}^  result,  end  in  handing  us  over  to  Father  Cha- 
ron for  ferriage  across  the  gloomy  Styx  long  before  our 
life's  journey  is  half  over.     It  is  true,  neither  the  savage 


Considerations  of  Eunuchism  and  Medicine.       113 

of  Africa  or  America  nor  the  nomads  of  Asia  are  sub- 
ject to  anj'  of  these  troubles  ;  but  with  us,  hampered 
with  all  the  benefits  of  the  dress,  diet,  habits,  and  luxu- 
ries of  civilization,  and  with  a  civilized  prostatic  glivnd, 
it  is  quite  otherwise.  Herein,  again,  comes  that  connec- 
tion between  religion,  morality,  and  medicine,  that  ex- 
isted with  so  much  benefit  to  mankind,  but  from  which 
we  of  later  daj^s  have,  in  our  greater  wisdom,  seen  fit 
to  separate  ;  although,  inconsistently  as  it  may  seem,  the 
present  age  has  done  more  than  any  previous  epoch  in 
practically^  demonstrating  the  intimate  and  inseparable 
relation  existing  between  the  physical  and  moral  nature 
of  man.  The  persistent  priapism  which  oftentimes  re- 
sults from  riding  with  a  wet  seat  and  the  inordinate  mor- 
bid sensibility  of  the  sexual  organs  that  may  result  from 
the  same  cause  or  from  spinal  irritation  are  not  to  be 
allayed  by  any  homily  on  morality  or  on  the  sanctiA'ing 
attempts  at  keeping  the  animal  passions  under  subjec- 
tion, any  more  than  will  praj^ers  or  oflTerings  to  all  the 
gods  of  Olj^mpus  restore  the  eunuchized,  either  through 
foolish  civilized  dress  and  customs  or  through  exces- 
sive indulgence.  We  must  mix  medicine  with  our 
religion  and  make  the  clergy  into  phj'sicians,  or  ordain 
our  physicians  into  full  fledged  clergymen. 

The  science  of  medicine,  or  what  might  be  called  the 
natural  ways  of  nature  through  its  physical  laws,  is  true 
to  itself;  the  fault  lies  in  our  interpretation  of  its  phe- 
nomena, which  we  fail  to  study  with  suflScient  discrimi- 
native precision  and  nicety.  We  have  repeatedly 
mistaken  causes  and  results  from  this  want  of  close  ob- 
servance and  of  precision,  attributing  results  to  causes 
which  did  not  exist.  As  an  example,  when  the  early 
disciples  of  homoeopathy  in  ancient  Palestine  under- 
took  to   revive   poor,   old,   withered  King   David,   by 


114  History  of  Circumcision. 

putting  him  to  bed  with  a  j^onng  and  caloric-generating 
Sunamite  maid,  when  it  was  by  like  incontinent  prac- 
tices that  he  had  brought  himself  to  that  state  of  decrepi- 
tude, it  is  plain  that  the}'  misunderstood  the  principle. 
Boerhaave — who,  as  a  true  eclectic  practitioner,  tbllow^ed 
these  ancient  and  Biblical  homoeopaths  in  their  practice 
in  a  similar  case,  the  subject  being  an  old  Dutch  burgo- 
master, whom  he  sandwiched  between  a  couple  of  rosy 
Netherland  maids — also  failed  to  grasp  the  true  con- 
dition of  the  nature  of  things,  or  the  true  philosophical 
explanation.  The  exhalations  from  the  aged  are  by  no 
means  an  elixir  of  health  or  life  to  tlie  young,  and  the 
fact  that  the  3'oung  were  apt  to  lose  health  by  sleeping 
■with  the  aged  was  wrongly  attributed  to  their  loss  being 
the  others  gain,  and  the  result  of  its  passing  into  the 
bodies  of  their  aged  companions,  and  not  to  its  true 
cause, — the  deteriorating  influence  to  which  the}-  were 
subjected  ;  and,  fuither,  when  we  analyze  the  subject 
still  more,  we  can  understand  how  a  full  blooded  and 
active,  lithe-bodied,  thin,  and  active-skinned  Sunamite 
maid  might  and  would  impart  caloric  to  King  David  ; 
but,  from  our  knowledge  (not  altogether  practical)  of 
the  difference  that  exists  between  differently  constitu- 
tioned  and  differently  built  maids  in  imparting  caloric, 
and  from  our  knowledge  of  the  physique  of  the  Nether- 
land  maids,  who  are  cold  and  impassive,  with  a  layer  of 
adipose  tissue  that  answers  the  same  purpose  as  that 
of  the  blubber  in  the  whale, — that  of  retaining  heat  and 
resisting  cold, — we  can  well  believe  that  the  poor,  shriv- 
eled burgomaster  could  receive  but  little  heat,  even 
when  sandwiched  between  the  two  ;  but,  on  the  contrary, 
he  was,  in  fact,  more  liable  to  lose  the  little  he  had,  un- 
less we  look  at  the  subject  in  another  light,  and  con- 
sider that  sentiment  that  is  common  to  both  animals  and 


Considerations  of  Eunuchism  and  Medicine.       115 

men  of  spirit,  a  sentiment  that  has  furnished  the  subject 
for  more  than  one  canvas  in  the  hands  of  the  true  and 
sjanpathetic  artist,  as  seen  on  the  awakening  and  alert 
attitude  of  the  worn-out  and  old  decrepit  war-horse, 
browsing  in  an  inclosed  pasture,  as  he  hears  from  afar 
the  familiar  bugle  notes  of  his  early  youth,  or  some 
cavalry  regiment  with  prancing  steeds  and  jingling 
accoutrements,  with  bright  colors  and  shining  arms, 
going  past  the  pasture,  restoring  for  a  time  to  the  stiflen- 
ing  joints  and  dim  eyes  the  suppleness  and  fire  of  bygone 
times,  with  visions  of  gallant  charges  and  prancing  re- 
views ;  or,  how  the  same  sentiment  erects  once  more  the 
bowed  and  withering  frame  of  the  old  veteran,  and  once 
again  fires  his  soul  with  the  martial  zeal  of  his  prime  as 
lie  sees  the  passing  colors  and  active-stepping  regiment 
which  he  followed  in  the  bright  sunshine  and  flush  of 
his  3'outh.  Aside  from  these  sentiments,  which  might 
possibly  have  inspired  David  and  the  Dutch  burgo- 
master with  an  infusion  of  a  new  and  transient  good 
feeling,  it  is  unquestionable  but  that  some  heated  brick- 
bats or  stove-lids,  curocoa  jugs  or  old  stone  Burton  ale- 
bottles  filled  with  hot-water,  would  have  been  more 
effectual  in  imparting  warmth  than  either  Sunamite  or 
Netherland  maids. 

It  is  hard  to  reconcile  the  beliefs  of  some  people  or 
nations  with  their  manners  and  customs.  For  instance, 
there  is  the  Turk ;  when  a  Jew  becomes  a  Mohammedan 
he  is  made  to  acknowledge  that  Jesus  Christ,  the  son  of 
Mar}'',  is  the  expected  Messiah,  and  that  none  other  is  to 
be  expected ;  they  know  of  Christ's  speech  on  the  cross, 
made  to  the  repentant  thief;  they  believe  in  a  heaven 
full  of  houris,  with  large  black  eyes  and  faces  like  the 
moon  at  its  full,  in  which  all  good  Moslems  are  to  have 
continual   rejoicings,  and  yet   they  go  on   performing 


116  History  of  Circumoision, 

the  most  barbarous  and  inhuman^  forms  of  castration 
imaginable,  wliich  not  only  deprives  its  victims  of  tbeir 
virility,  but  subject  more  than  three-fourths  of  those 
operated  upon  to  a  painful  death,  and  the  remaining  to 
a  life  of  continual  misery.  Have  these  poor  subjects  no 
right  to  future  bliss,  or  in  what  shape  will  they  reach 
there  ?  If  the  heavens  of  these  eunuchisers  were  like  the 
heaven  of  Buddhism,  or,  as  the  Chinese  call  it,  the  Para- 
dise of  the  West,  where,  although  all  forms  of  sensual 
gratifications  are  to  be  enjoyed,  no  houris  are  to  be  sup- 
plied to  the  saints  of  Buddhism, — as  even  the  women  who 
enter  this  paradise  must  first  change  their  sex, — we  might 
understand  that,  the  genitals  not  being  needed  in  the 
eternal  world,  it  might  be  considered  a  matter  of  small 
moment  to  compel  a  man  to  go  through  this  short  and 
transient  life  without  them;  but  where  a  robust  con- 
dition of  the  sexual  organs  is  suggested  as  one  of  the 
heavenly  requisites,  it  would  seem  as  if  the  Turk  would 
look  upon  the  suffering,  misery,  and  death  that  they 
cause,  in  connection  with  the  inhuman  mutilation  they 
inflict,  with  horror.  Doctrinal  theologj'^,  whether  in  the 
East  or  West,  is  something  incomprehensible. 


CHAPTER  X. 
Hermaphrodism  and  Hypospadias. 

There  exists  a  class  of  human  beings  whose  descrip- 
tion is  connected  with  the  subject  of  this  work.  Tliey 
date  bade  to  mythological  times,  and  the  confusion  inci- 
dent to  the  misapplication  of  names  and  the  want  of 
proper  observation  on  the  part  of  the  narrators  has  tended 
to  carry  the  uncertainty  of  their  real  existence  to  the 
present  day.  One  reason  that  this  part  of  the  subject 
would  be  incomplete  without  their  description  is  on 
account  of  the  origin  of  their  existence  being  intimately 
connected  wuth  eunuchism,  being,  in  fact,  an  outgrowth 
of  this  condition;  and  any  history  of  eunuchism  would 
be  but  lialf  told,  without  the  additional  information 
concerning  these  persons. 

Hermaphrodites,  as  stated,  date  back  to  mytholog3'. 
Tradition  tells  us  that  Hermaphroditus,  a  son  of  Venus 
and  Mercury,  was  educated  by  the  Naiades  dwelling  on 
Mount  Ida.  At  the  age  of  fifteen  3'ears,  he  began  his 
travels  ;  while  resting  in  the  cool  shades  on  the  wood 3'^ 
l)anks  of  a  fountain  and  spring  near  Caira,  he  was 
approached  bj'  the  presiding  nj'mph  of  the  fountain, 
Talmacis,  wlio.  becoming  enamored  of  him,  attempted 
to  seduce  him.  Hermaphroditus,  like  Joseph,  was  the 
pattern  and  mirror  of  continence,  and  would  not  be 
seduced.  Talmacis  then,  like  Potiphar's  wife,  seized  on 
the  unluck}'  pattern  of  virtue,  and  praj^ed  to  the  gods 
that  they  should  so  amalgamate  poor  Hermaphroditus 
to  her  body  as  to  make  them  one.  The  prayer  was 
heard  on  Olympus,  and  forthwith  the  two  became  one, 

(117) 


118  History  of  Circumcision. 

but  with  the  distinctive  characteristics  of  each  sex  un- 
changed. Thus  began  that  fabled  race  of  the  androgynes 
of  the  ancients.  Another  tradition,  which  is  probably 
correct,  affirms  that  ancient  Carnia,  or  Halicarnassus, 
was  in  those  days  the  Baden-Baden  of  Asia  Minor  ;  that 
thither  repaired  all  the  victims  of  gluttonj',  debauchery, 
and  general  physical  bankruptcy.  Its  name  in  ancient 
Caria  denotes  its  seaside-resort  location,  Hali-Karnas- 
Sos  meaning  literally  "  Karnassus-b3'-the-sea,"  like 
Boulogne-sur-mer.  The  city  was  under  the  protection 
of  Hermes  and  Aphrodite,  whose  temples  were  near 
each  other.  Human  nature  in  the  days  of  Halicarnas- 
sus did  not  much  differ  from  human  nature  at  Monte 
Carlo  or  Baden-Baden.  The  baths  had  a  number  of 
3'oung  and  handsome  eunuchs  who  waited  on  the  old, 
debauched,  and  nervous  wrecks,  and  the  nj'mph  who 
presided  over  the  whole  was  Talmakis,  a  name  derived 
from  the  salty  nature  of  the  springs  which  fed  the 
baths ;  this  nymph  was  worshiped  as  Aphrodite. 
Pederasty  was  one  of  the  practices  at  these  baths.  From 
these  conjoined  conditions  the  place  was  said  to  be  peo- 
pled with  hermaphi'odites, — meaning,  at  first,  simply  that 
they  were  under  the  protection  of  Hermes  and  Aphro- 
dite; and  latterly  the  name  was  attached  to  the  passive 
agent  in  the  pederastic  art, — a  name  that  has  followed 
the  class  and  crossed  the  ocean  into  the  interi'or  wilds 
of  America,  as  in  Powell's  history  of  the  manners  and 
customs  of  the  Omahas,  an  Indian  tribe  of  the  Missouri, 
we  find  that  they  at  times  practiced  pederast}^,  the 
passive  agent  being  called  by  the  Indians  an  hermaphro. 
dite,  or  double  sexed.^ 

The  relations  that  from  eunuchism  led  to  pederasty 
are  very  easy  of  explanation.  Eunuchism  induces  an 
effeminate  form,  softer  body,  and  prevents  the  growth 


Hermaphrodism  and  Hypospadias.  119 

of  the  beard  ;  the  voice  is  softer  and  more  melodious ; 
and  tlieir  timidity  renders  them  also  more  effeminate, 
obedient,  and  dependent.  The  peculiar  commingling 
of  the  female  form  with  that  of  tiie  male  furnished 
to  the  sculptors  the  models  for  those  wonderfully  well- 
made  forms  which  are  yet  to  be  seen,  representing  in 
statuary  the  forms  of  Androgjmes  and  Hermaphrodites  ; 
tnat  of  the  favorite  eunuch  of  the  emperor  Adrian 
being  remarkable  for  the  symmetry  of  its  form  and 
grace  of  pose. 

Europe  must  have  been  astonished  at  the  tales  that 
were  carried  back  by  the  early  explorers  and  voyagers, 
in  relation  to  the  New  World.  The  story  of  the  im- 
mensity of  the  quantity  of  gold  and  silver,  of  great 
stores  of  hidden  treasures,  of  the  quantities  of  precious 
gems  and  priceless  crystals  was  full}'  discounted  when, 
from  the  Florida  coast  and  the  explorers  of  the  Lower 
Mississippi,  men  returned  with  the  tale  that  in  the 
everglades  and  in  the  trackless  forests,  intersected  by 
navigable  sloughs,  there  dwelt  a  people  half  of  whom 
were  hermaphrodites.  Neither  the  explorers  nor  their 
European  historiographers  seem  able  to  have  grasped  the 
true  state  of  affairs.  Many  believed  in  the  actual  exist- 
ence of  such  numbers  of  these  monstrosities,  while 
others,  arguing  from  what  was  then  known  regarding 
the  extraordinary  development  of  the  nymphse  and 
clitoris,  as  well  as  of  the  great  labia,  of  the  women  in 
tlie  African  regions,  concluded  that  these  supposed 
androgynes^  or  hermaphrodites,  must  be  women,  the 
dress  assumed  by  these  and  the  menial  labors  to  which 
they  were  consigned  assisting  to  favor  this  opinion. 
The  early  Franciscan  missionaries  to  California  found 
the  men  who  were  used  for  pederasty  dressed  as 
woinen.^^       Hammond    mentions    the    practice    as    in 


120  History  of  Circumcision. 

vogue  among  the  Indians  of  the  southwest,  which 
in  a  measure  greatly  reseml)led  that  of  the  ancient 
Scythians  in  its  operation,  the  men  being  dressed  as 
women,  associating  with  women,  and  used  for  pederastic 
purposes  during  the  orgies  of  their  festivals.  These  men 
had  previously  been  eunuchised  b}'  a  process  of  con- 
tinued and  persistent  onanism,  which  caused  at  the  end 
a  complete  atrophization  of  the  testicle. 

In  regard  to  the  great  number  of  hermaphrodites 
observed  in  Florida  and  on  the  Mississippi,  the  accounts 
are  only  reliable  as  far  as  they  were  present  in  female 
garb  and  in  an  apparent  state  of  slavery,  being  com- 
pelled to  do  all  the  menial  labor  of  the  villages  and 
camps,  besides  being  used  for  pederasty,  no  examina- 
tion having  been  made  by  any  traveler.  Their  lot  was 
different  from  those  described  by  Hammond  in  his  work 
on  "  Male  Impotence,"  where  the  whole  transaction 
seems  to  have  some  sort  of  religious  and  civil  signifi- 
cance. In  Florida,  however,  they  tilled  the  ground,  ex- 
tricated and  carried  off  the  dead  during  a  battle,  and  did 
all  the  work  generall}^,  being  used  for  beasts  of  burden 
and  not  allowed  to  cut  their  hair ;  but  all  authorities  are 
silent  or  in  complete  ignorance  as  to  whether  they  had 
suffered  castration.  Pere  Lafiteau,  however,  gives  an 
explanation  which  was  in  the  last  century  considered 
ridiculous,  but  which,  in  the  light  that  has  been  thrown 
on  the  existence  of  a  former  continent,  and  of  the  un- 
disputable  relation  that  must,  some  ages  in  the  past, 
have  existed  between  Phoenicia  and  Central  America, 
seems  a  strongl}^  probable  solution  of  these  customs. 
The  Father  accounts  for  the  presence  of  these  American 
androgynes  in  the  following  manner :  The  Carribeans, 
or  Caribs,  were  originallj'  a  colony  from  Carnia ;  with 
these  colonists  was  brought  over  the  worship  of  their 


Herviaphrodism  and  Hypospadias.  121 

Pagan  gods  of  Caria  and  Pliiygia ;  tliese  two  localities 
were  the  homes  of  the  Cybelian  priesthood,  who  dressed 
in  female  garb,  as  did  the  sacrificial  priests  of  the 
Temple  of  Yenus  Urania.  It  is  true  that  the  Java  or 
Floridian  priest  had  nothing  in  common  with  the  priests 
of  Cjbele  or  of  Venus  Urania;  but,  still,  Lafiteau  gave 
as  lucid  an  explanation  for  the  existence  of  these  con- 
ditions as  an}'  of  his  contemporaries.  Charlevoix  ob- 
served the  same  practices  among  the  Ulinoi-s,  which  he 
attributed  as  being  due  to  some  principle  of  religion. 
The  Baron  de  la  Hontan  insists  tliat  the  missionary, 
Charlevoix,  was  mistaken  ;  that  the  persons  whom  he  saw 
in  female  attire,  whom  he  took  to  be  men,  were  not  men. 
Hontan  asserts  that  they  were  veritable  hermaphrodites. 
The  missionaries  were,  however,  correct,  as  wliat  has 
since  been  observed  confirms  their  opinion.  M.  du 
Mont,  who  ascended  tlie  Mississippi  for  a  distance  of 
nine  hundred  leagues,  also  reported  meeting  Indians 
at  different  places  attended  by  these  petticoated  andro- 
g^'nes.*** 

As  strange  as  it  may  seem,  many  intelligent  men  were 
loth  to  part  with  their  belief  in  the  existence  of  these 
double-sexed  individuals;  the  logic  used  by  manj'  of 
these  insisters  of  hermaphrodism,  although  now  very 
ridiculous,  was  no  doubt  sensible  logic  one  hundred  and 
fifty  years  ago.  As  a  matter  of  curiosity,  some  of  this 
reasoning  will  bear  repeating.  It  is  taken  from  a  Latin 
edition  of  an  ancient  description  of  Florida,  originally 
in  the  English,  but  translated  into  the  Latin  by  the 
geographer,  Mercator.  In  this  book  we  find  the  roots 
of  some  of  the  myths  that  led  Ponce  de  Leon  and  his 
steel-clad  warriors  to  wander  through  Florida  in  a  A'ain 
search  of  that  spring  or  fountain  of  the  waters  of  per- 
petual youth  and  of  everlasting  life  which  they  were 


122  History  of  Circumcision. 

never  to  find.  We  there  learn  that,  in  the  daj'S  of  the 
good  old  Spanish  knight,  the  inhabitants  of  Florida 
lived  to  a  very  old  age,  and  that  they  did  not  marry 
until  very  late  in  life,  as  before  that  period  it  was  A^ery 
difficult  to  determine  the  sex  of  the  individual. 

From  what  has  since  been  seen  among  the  Indians, 
the  pi'obability  is  that  these  were  really  eunuchs,  and 
probably  in  slaver}'^,  as  the  result  of  the  fortunes  of  war, 
as  their  great  number  and  servile  condition  will  hardly 
admit  of  the  belief  that  they  belonged  to  the  same  tribe 
as  their  masters  and  oppressors.  Pederasty  was  an  old, 
very  old  practice,  being  mentioned  before  circumcision; 
it  prevailed  among  many  of  the  Orientals,  and  among 
the  many  peoples  by  whom  the  early  Jews  were  sur- 
rounded, who  were,  according  to  the  Old  Testament, 
about  as  an  immoral,  dissolute,  and  bestial  a  set  as  one 
could  well  imagine.  Their  religions  were  nothing  but  a 
gross  mixture  of  stupid  superstition  and  blind  idolatry, 
pederasty,  fornication,  and  general  cussedness.  In  the 
then  state  of  the  Jewish  nation,  to  have  allowed  them  to 
mingle  freely  with  these  people  would  have  ended  in 
having  the  Jews  adopt  all  their  customs  and  habits. 
The  aim  of  the  Jewish  leaders  was  to  prevent  any  too 
free  intercourse  of  their  people  with  these  nations,  that 
they  might  remain  uncontamlnated  even  while  dwelling 
near  them.  To  accomplish  this  it  was  necessary  to  raise 
a  barrier  that  would  be  the  distinguishing  mark  of  the 
Jewish  nation.  Jahns,  in  his  learned  work  on  the  "  His- 
tory of  the  Hebrew  Commonwealths,"*^  lays  down  the 
idea  that  circumcision,  as  well  as  many  articles  in  their 
laws, — which  to  us  appear  trivial, — were  in  reality  in- 
tended to  separate  the  Jews  farther  and  farther  from 
their  idolatrous,  bestial,  and  heathenish  neighbors,  while 
at  the  same  time  these  same  ordinances  were  intended 


Hermaphrodism  and  Hypospadias.  123 

to  presei'A^e  a  constant  knowledge  of  the  true  and  only 
God,  and  maintain  their  moral  and  physical  health. 

Although  hermaphrodism  on  a  large  scale,  as  an  ex- 
isting condition,  was  a  matter  of  serious  belief  at  the 
end  of  the.  eighteenth  centur^^  it  has  occupied  no  little 
attention  in  this.  Courts  have  been  called  to  decide  on 
cases  to  invalidate  marriages,  or  to  decide  the  sex,  more 
than  once ;  and  physicians  are  often  asked  the  question, 
Do  hermaphrodites  reall^^  exist  ?  Dr.  Debierre,  of  Lyons, 
published  in  1886  a  valuable  paper,  entitled  "  Hermaph- 
rodism Before  the  Civil  Code:  its  Nature,  Origin,  and 
Social  Consequences,"  which  was  published  in  the 
Archives  of  Criminal  Anthropology  of  Lyons,  Frnnce. 
In  this  short  but  very  concise  treatise,  Debierre  gives 
us  a  complete  review  of  the  subject  from  m3'thological 
times  to  1886.  It  must  be  quite  evident  to  all  that 
there  exists  no  logical  reasons  why  the  sexual  or  gen- 
erative organs  should  be  exempt  from,  at  times,  being 
subject  to  variations  from  the  normal,  either  through 
the  commingling  of  two  conceptions  or  of  faulty  devel- 
opment affecting  other  parts  of  the  bod}^ — conditions 
that  go  to  form  monstrosities.  Debierre  gives  one 
peculiar  case  of  a  duplication  of  vagina  and  uterus  in  a 
girl  of  nineteen,  the  appearance  of  the  parts  and  the 
septum  between  the  vaginge  giving  to  the  whole  an  ap- 
pearance precisely  similar  to  that  of  a  double-barreled 
shot-gun.  These  monstrosities  are  as  likelj'  to  happen 
as  the  different  forms  that  affect — either  by  arrested 
development  or  some  abnormality  of  excessive  develop- 
ment— the  head,  which  is  a  vary  prolific  subject  of 
anomalies. 

Hermaphrodism  is  a  common  attribute  in  the  vege- 
table kingdom,  where  fixed  habitation  or  position  makes 
such  a  condition  necessary  ;  it  is  also  common  to  many 


124  History  of  Circumcision. 

of  our  lower  forms  of  animal  life,  and  even  in  the  human 
fcetus  the  presence  of  the  Wolfian  bodies  and  tlie  canal 
of  Miiller  in  the  same  individual  attest  a  primitive  case 
or  condition  of  hermaphrodisra.  In  other  words,  hu- 
manity begins  its  existence  in  a  state  of  hermaphrodism. 
Tliis  condition  is  found  up  to  the  end  of  the  second 
month  of  foetal  life  in  the  human  being,  in  common  with 
all  mammals,  as  well  as  all  tlie  vertebrates,  where,  how- 
ever, it  is  subject  to  variationsas  to  time  of  development 
and  limit  of  existence  in  the  normal  condition.  In  tlie 
chick,  it  is  Qx\\y  after  the  fourth  day  that  the  genital 
gland  begins  to  determine  whether  it  will  turn  into  an 
ovary  or  a  testicle ;  in  the  I'abbit  it  is  on  the  fifteenth 
day,  and  in  the  human  embryo  on  the  thirtieth  day. 
Hermaphrodism  does  not  occur,  however,  from  this  at 
first  uncertain  state  of  affairs,  but  rather  from  subse- 
quent developments  of  the  external  organs  that  by  their 
abnormality  of  formation  simulate  one  or  the  other  sex, 
while  the  internal  organs  xn^iy  belong  without  any  equivo- 
cation of  structure  to  its  definite  pex  ;  as  it  has  often 
happened  that  some  of  these  cases,  having  been  the  sub- 
ject of  differences  of  opinion  among  experts  during  life, 
were,  after  death,  unanimously  assigned  to  one  sex  by 
all  of  the  same  experts,  the  organs  readily  defining  the 
sex  being  completely  of  the  one  sex.  As  observed  by 
Debierre,  where  the  subject  is  reall}'^  a  female,  even  where 
the  vagina  or  uterus  is  unperceived,  the  presence  of  the 
menstrual  function  or  some  physical  disturbance  at  its 
stated  periods  are  sufficient  evidences,  as  a  rule,  by  which 
to  determine  the  sex.  The  case  of  Marzo  Joseph,  or 
Josephine,  reported  by  Crecchio  in  1865,  had  rudiments 
of  an  hj'pospadic  penis  ten  centimetres  in  length  and 
a  prostate  of  the  male  sex,  with  a  vagina  6  centimetres 
in  length  and  4  in  circumference,  ovaries,  oviducts,  and 


Hermaphrodism  and  Hypospadias.  125 

uterus  of  the  female ;  it  was  not  until  her  death,  at  the 
age  of  fifty-six,  that  her  sex  was  fully  determined.  The 
case  reported  by  Sippel  in  1880,  supposed  to  be  a  male 
from  external  evidences,  was  at  death  found  to  be  a 
female.  Guttmann  reported  a  like  case  in  1882.  The 
celebrated  case  of  Michel-Ann  Dronart  is  remarkable ; 
this  case  was  declared  a  male  by  Morand  .Pere  and  a 
female  by  Burghart,  as  well  as  b}^  Ferrein  ;  declared 
asexual  or  neutral  by  the  Danish  surgeon,  Kruger;  of 
doubtful  sex  by  Mertrud.  The  case  of  Marie-Madeleine 
Lefort,  to  which  Debierre  devotes  four  figures,  is  full 
of  interest.  One  of  the  figures  is  her  portrait  at  the  age 
of  sixteen,  and  another  is  from  her  photograph  at  the 
age  of  sixty-five.  She  has  a  man's  head  in  everj'^  par- 
ticular of  physiognomy  and  expression,  having  in  the 
latter  figure  a  full  beard  and  the  peculiar  intellectual 
development  of  a  male  sage  ;  she  has  the  hairy  breast  of 
the  man,  with  the  mammary  development  of  the  female, 
and  an  abnormally-enlarged  clitoris,  which  was  often 
mistaken  for  the  male  organ.  The  vagina  at  its  lower 
end  was  nai'row,  and  the  urethral  aperture  opened  into 
it  some  distance  from  its  outer  opening  ;  otherwise  she 
was  sexually  a  perfect  woman,  and  menstruated  regularlj'. 
Debierre  quotes  the  case  which  Duval  gives  in  his  work 
on  hermaphrodites,  wherein  a  man  asked  for  a  dissolu- 
tion of  marriage,  claiming  that  his  wife  had  a  male  organ, 
which,  although  she  was  a  woman  in  everj'^  other  sense, 
prevented  by  its  interference  the  consummation  of  the 
marriage  act.  The  court  had  the  case  examined,  when 
it  was  found  that  the  erection  of  the  clitoris,  which  was 
large,  was  enough  to  interfere  as  the  husband  had  stated. 
It  decreed  that  the  young  woman  should  have  the  ob- 
jectionable and  interfering  member  amputated,  and  on 
the  refusal  to  have  this  done  the  marriage  should  be 


126  History  of  Circumcision. 

dissolved.     She   refused,  and   the    divorce   was  conse- 
quently granted  to  the  man. 

From  the  history  of  Marie  Lefort,  it  can  well  be 
conceived  how  the  popular  mind,  in  ignorant  times, 
could  easily  be  imposed  upon.  Montaigne  relates  the 
history  of  a  Hungarian  soldier  who  was  confined  of  a 
well-developed  infant  while  in  camp,  and  of  a  monk 
brought  to  a  successful  accouchement  in  the  cell  of  a 
convent;  while  Duval  reports  the  case  of  a  priest  in 
Paris  who  was  found  to  be  pregnant  with  child,  who 
was  in  consequence  imprisoned  in  the  prison  of  the 
ecclesiastical  court.  These  cases  were  strongly  females 
in  every  sense,  but  with  some  male  characteristic  suffi- 
ciently developed,  like  in  the  case  of  Marie  Lefort,  to 
allow  them  to  believe  themselves  men  and  to  pass  for 
such. 

On  the  other  hand,  males  have  had  some  female 
characteristics  so  well  pronounced  that  they  have  passed 
for  females.  Debierre  mentions  a  number  of  cases,  to 
wit:  Ambroise  Pare  reported  such  a  case  in  his  time; 
Ladowsky,  of  Reims,  reports  the  case  of  Marie  Goulich, 
who,  up  to  the  age  of  thirtj'-tliree,  was  believed  to  be 
a  female,  at  which  time  the  descent  of  the  testicles  re- 
moved all  doubts  as  to  sex.  Sheghelner  and  Cheselden 
have  reported  analogous  cases,  and  Giraud's  case — who 
was  happil3'^  married  to  a  man  with  whom  he  lived  until 
the  death  of  the  husband,  in  which  the  only  female 
attribute  was  a  blind  vagina,  which,  in  his  case,  seems 
to  haA'^e  answered  all  purposes — was  a  most  remarkable 
case.  As  a  rule,  the  cases  of  males  who  have  been  mis- 
taken for  hermaphrodites  have  been  cases  of  h3'pospadic 
urethrse  in  a  greater  or  lesser  sense  of  deformit3^ 

Debierre,  however,  mentions  some  cases  of  true 
hermaphrodism.     He   quotes   a   number   of    cases,  the 


Hermaphrodism  and  Hypospadias.  127 

earliest  being  from  the  writings  of  Coelius  Rhodigin, 
who  claimed  to  have  seen  in  Lombardy  a  case  in  which 
the  organs  of  the  two  sexes  were  side  by  side ;  Ambroise 
Pard  records  that  in  1426  a  pair  of  twins  were  born, 
joined  back  to  back,  wherein  both  were  hermaphrodites. 
Among  the  many  reporters  that  he  quotes,  he  mentions 
Rokitansky,  who  reported  a  case  in  1869,  at  Vienna, 
this  being  the  autopsy  of  Hohmann,  who  had  two  ovaries 
and  oviducts,  a  rudimentary  uterus,  and  a  testicle, 
with  a  sperm-duct  containing  spermatozoa.  This  in- 
dividual menstruated  regularly,  and  it  is  an  interesting- 
question  as  to  what  the  result  would  have  been  had 
some  of  the  spermatic  fluid  come  in  contact  with  some 
of  the  ovules  that  were  periodically  discharged.  Hoh- 
mann had  an  imperforate  penis  and  a  bifide  scrotum. 
Ceccherelli,  who  gives  a  more  minute  description  of  this 
interesting  case,  relates  that  Hohmann,  who  died  at  tlie 
age  of  fort}',  had  menstruated  regularly  to  the  age  of 
thirty-eight.  The  penis  was  imperforate  but  hypospadic, 
from  whence  came  the  urinary  and  spermatic  discharges, 
and  Hohmann  could  in  turn  copulate  as  either  male  or 
female.  Odin  is  also  quoted  in  relation  to  the  case  seen 
at  the  H6tel-Dieu-de-L3'on,  during  the  service  of  M. 
Bondet.  The  subject  was  aged  sixt3r-three,  and  named 
Mathieu  Perret.  The  case  greatly  resembled  that  of  Holi- 
mann,  at  the  autopsj-  being  found  to  be  double  sexed. 
So  that,  while  most  of  the  cases  mentioned  are  fictitious 
and  only  apparent,  the  fact  remains  that  the  existence 
of  true  hermaphrodites  is  indisputable.^ 

If  the  subject  of  either  apparentl}'^  or  true  hermaph- 
rodism is  one  of  unhappiness,  and  oftentimes  of  dis- 
comfort and  miser}',  history  relates  that  this  unfortunate 
class  has  suffered  additionall}'^,  from  the  laws  and  ac- 
tion of  ignorant  and  barbarian  times,  as  such  freaks  of 

5 


128  History  of  Circumcision. 

nature  must  of  necessity  have  occurred  at  all  times  ; 
only  in  the  then  ignorant  state  of  medicine  and  anatomy 
they  must  have  been  considered  as  occurring  much 
oftener — every  deviation  from  the  normal  being  con- 
sidered as  hermaphroditic.  Opmeyer  relates  that  in  ex- 
cavating in  the  neighborhood  of  the  capitol  in  Rome, 
the  laborers  discovered  the  bronze  tables  on  which  were 
inscribed  the  twenty-two  laws  of  Romulus,  termed  by 
many  historians  "  The  Double  Decalogue  of  Romulus." 
Article  XV  of  this  law,  as  well  as  Articles  IX  and  X, 
seem  to  be  directed  against  the  life  of  these  androgynes. 
In  Roman  history,  however,  we  have  an  event  whicli 
would  seem  to  contradict  that  there  existed  any  laws,  in 
actual  force  against  this  unfortunate  class.  It  hap- 
pened during  the  existence  of  the  Punic  wars,  when  the 
people  were  more  or  less  laboring  under  fear  and  excite- 
ment, which  would  readily  prepare  them  to  accept  any 
superstitious  notion.  It  was  during  these  times  that 
three  of  these  androgynes  were  known  to  exist  in  Italy. 
Titus  Livius  mentions  that  the  existence  of  one  of  these 
was  denounced  during  the  consulships  of  C.  Claudius 
Nero  and  of  Marcus  Livius,  Etruscan  soothsayers  and 
seers  were  summoned  to  Rome,  that  they  might  con- 
sult the  signs  and  the  conditions  of  the  constellations 
tliat  accompanied  the  nativity  of  this  hermaphrodite, 
or  androgyne.  These  impostors,  after  a  careful  con- 
sultation of  airattending  circumstances,  gave  it  as  their 
opinion  that  the  occurrence  was  an  unfortunate  im- 
purity, and  that  it  could  only  result  to  the  disadvantage 
of  Rome,  unless  she  at  once  took  steps  to  purify  her- 
self of  such  a  monstrosity,  with  the  conclusion  that  the 
androgyne  should  be  first  exiled  from  Roman  soil,  and 
then  drowned  in  the  depths  of  the  sea.  The  unfortunate 
being  was  accordingly  inclosed  in  a  chest  and  put  on 


ffermaphrodism  and  Hypospadias.  1 29 

board  a  galley,  which  put  immediately  to  sea;  when  the 
vessel  was  out  of  sight  of  land  the  chest  was  thrown 
into  the  Mediterranean.*^ 

A  hermaphrodite  born  in  Umbria  during  the  consul- 
ship of  Messalus  and  C.  Lucinins  was  condemned  to 
death,  as  well  as  was  the  one  born  at  Luna  during  the 
consulship  of  L.  Matellus  and  Q.  Fabius  Maximus.  De- 
bierre  states  that  in  the  reign  of  Nero  this  barbarous 
custom  was  discontinued,  as  this  emperor  admired  these 
freaks  of  nature  from  their  novelty,  as  it  is  related  that 
his  chariot  was  drawn  by  four  hermaphroditic  horses.^ 

In  connection  with  hermaphrodism  it  has  been  shown 
that  the  males  who  have  been  supposed  to  be  so  mal- 
formed were  reallj'^,  in  most  instances,  but  cases  of 
hypospadias.  It  ma^^  not  be  uninteresting  to  observe 
that,  while  during  nearly  four  thousand  j-ears  circum- 
cision has  been  practiced  without  the  habit  or  condition 
ever  having  become  transmissible  or  hereditary,  h^-po- 
spadias  has  shown  a  decided  tendency  to  being  trans- 
mitted. In  Virchow's  Archives,  Lesser  reports  having 
treated  eight  subjects  during  one  generation  in  a  famil3'.*' 
Fodere  records  the  case  of  In^pospadias  reported  by 
Schweikard,  in  a  person  of  forty-nine  years  of  age, 
whose  urethral  orifice  was  near  the  junction  of  the 
penis  and  scrotum,  but  who,  neA'ertheless,  had  three  fine 
children.  The  same  author  records  the  remarkable  case 
reported  by  Hunter  to  the  Royal  Soeietj''  of  London, 
also  so  deformed,  who  successfully  impregnated  his  wife 
by  receiving  the  spermatic  fluid  in  a  warm  spoon  and 
immediately  injecting  it  into  the  vagina.^  Another 
interesting  case  is  taken  from  L'' Union  3Iedicale  of 
August  26,  1856.  It  instances  both  the  heredity  con- 
nected with  hj'pospadias  and  the  peculiar  circumstances 
under  which  impregnation  at  times  takes  place ;   it  is 


130  History  of  Circumcision. 

reported  by  Dr.  Trexel,  of  Kremsier,  and  is  as  follows : 
"  On  April  1,  1856,  a  newborn  infant  was  brought  to  Dr. 
Trexel,  that  he  might  determine  its  sex.  The  father  and 
mother  were  servants  of  a  peasant.  On  an  examination 
of  the  alleged  father,  he  was  found  to  have  all  the  ex- 
ternal characters  of  a  male  ;  the  urethra,  which  was 
rather  shorter  than  ordinary,  but  of  large  size,  was  ira- 
perforate ;  the  scrotum  was  divided  into  two  pouches, 
each  containing  a  testicle.  The  apposed  surfaces  of  the 
scrotal  pouches  were  covered  with  a  red  skin,  and  the 
division  extended  through  their  entire  length.  At  the 
root  of  the  penis,  in  the  anterior  angle  of  these  pouches, 
was  an  opening  of  the  size  of  a  lentil ;  this  was  the 
orifice  of  the  urethra.  The  lower  surface  of  the  penis 
was  grooved  from  the  above-mentioned  orifice  to  the  end 
of  the  glans.  There  was  no  prepuce.  Almost  in  a  line 
behind  the  corona  of  the  glans,  and  in  the  groove,  were 
two  elliptical  openings,  which  readily  admitted  a  large 
hog-bristle ;  there  was  a  third  smaller  opening  two 
lines  from  the  orifice  of  the  urethra.  This  man  had 
always  passed  for  a  woman.  He  lay  in  the  same  room 
with  the  mother  of  the  child  ;  and  they  acknowledged 
having  had  frequent  connection.  The  woman  declared 
that  she  had  had  no  commerce  with  any  other  man  for 
three  years,  and  the  man  did  not  deny  this  assertion. 
The  idea  of  cohabitation  with  another  man  was  further 
negatived  by  the  circumstance  that  the  infant  had  the 
same  conformation  of  the  genital  organs  as  the  father. 
How  did  fecundation  take  place  ?  The  three  openings 
in  the'penis  were  pi'obably  the  orifices  of  the  excretory 
ducts  of  Cowper's  glands.  But  might  not  these  have 
been  the  openings  of  the  ejaculatoi'y  ducts?  It  is  to  be 
regretted  that  Dr.  Trexel  did  not  examine  these  canals ; 
their  length  and  direction  would  have  thrown  light  on 


Herviaphrodism  and  Hypospadias.  131 

the  subject.  The  fact  of  fecundation  may  also  be  ex- 
plained by  supposing  that  during  coition  the  posterior 
wall  of  the  vagina  supplied  the  place  of  the  absent  floor 
of  the  urethra,  thus  forming  a  complete  canal.  This  is 
the  most  probable  explanation."^^ 

The  above  case,  as  stated,  had  passed  for  a  woman ; 
these  cases  are  by  no  means  such  rarities.  The  case  of 
Marie  Dorothee,  mentioned  by  Debierre  in  his  work, 
was  as  peculiar,  Hufeland  and  Marsina  had  pronounced 
Marie  a  woman,  while  Stark  and  Martens  pronounced 
her  a  man,  and  Metzger  could  not  determine  on  the  sex. 
The  case  of  Valmont,  noticed  by  Bouillaud  and  Manee, 
is  on  a  par  with  that  of  Giraud,  in  which  the  party  was 
married  as  belonging  to  one  sex  and  where  it  was  not 
until  after  death  ascertained  that  the  person  belonged  to 
the  other  sex.  Valmont  had  a  hypospadic  urethi'a  and 
penis  ;  a  scrotum  witliout  testicles ;  ovaries  with  the 
Fallopian  tubes ;  a  uterus  opened  into  a  vagina  of  two 
inches  in  length,  which,  gradually  narrowing,  ended  in 
tiie  male  urethra,  to  which  was  attached  a  prostate 
gland.  Valmont  contracted  marriage  as  a  man  and  was 
not  discovered  to  have  been  a  female  until  the  autopsy 
revealed  her  to  be  a  woman.  The  relation  does  not 
state  anything  in  regard  to  menstruation;  so  that  her" 
condition  in  that  regard  is  unknown.*^ 

There  has  also  been  reported  a  number  of  cases  in 
the  male  analogous  to  the  double  organed  female  men- 
tioned by  Debierre.  Geoffrey  St.  Hilare  reports  a  case 
where  the  penis  was  double,  one  being  above  the  other, 
urine  and  semen  flowing  through  both  urethras.  Gore 
mentioned  a  like  case  to  the  Academy  in  1844. 
Dr.  Vanier  (Du  Havre)  records  the  case  reported  by 
Huguier  to  the  Academ^^,  where  the  organs  in  the  ana- 
tomical preparation  which  he  exhibited  were  so  anoma- 


132  History  of  Circumcision. 

lous  that  it  was  impossible  to  decide  the  sex.  Aside 
from  the  medico-legal  aspects  that  these  cases  present, 
there  is  an  interesting  Jewish  theological  question  con- 
nected with  them.  The  law  is  explicit  as  to  circum- 
cision ;  the  cases  presenting,  if  males,  should  be  circum- 
cised, but  how  to  determine  the  sex  where  an  autopsy 
alone  will  decide  the  question  is  not  defined.  It  has 
been  decided,  in  such  cases  whei'e  the  presumption  is 
that  the  child  is  of  the  male  sex,  that,  like  in  cases  of 
absence  of  prepuce,  a  suppositious  circumcision  should 
be  performed,  so  that  the  covenant  should  be  observed ; 
this  being  in  keeping  with  the  sentiment  sliown  by  the 
Jews  when  persecuted  by  the  Romans,  or,  later,  by  the 
Spaniards,  who  often  were  not  able  to  circumcise  until 
after  death ;  but  they  never  fail  to  comply  with  the 
covenant  as  far  as  it  is  possible. 

Cases  are  liable  to  occur,  however,  which,  without 
leaving  the  question  as  to  sex  in  doubt,  if  reasoned  by 
exclusion,  would  not  furnish  any  possible  opportunity 
for  circumcision.  Such  a  case  is  reported  in  Virchow's 
Archives,  vol.  cxxi.  No.  3 ;  also  in  tlie  British  Medical 
Journal  of  December  6,  1890,  and  in  the  Satellite  for 
January,  1891.  It  is  one  of  congenital  absence  of  penis. 
"  Dr.  Rauber  records  very  briefly  the  case  of  a  shoe- 
maker, aged  38,  who  complained  of  pain  and  trouble  in 
the  anus.  On  examining  him,  Rauber  found  a  well- 
formed  scrotum  containing  two  testicles,  each  With  a 
vas  defei-ens  and  spermatic  cord,  but  no  trace  of  a  penis. 
The  urethra  opened  apparently  into  the  anterior  wall  of 
the  rectum.  The  man  occasionally  experienced  sexual 
excitement,  followed  by  an  emission  into  the  rectum. 
The  burning  pain  complained  of  in  the  rectum  and 
about  the  anus  was  due  to  the  irritation  caused  by  the 
urine.     The  man  would  not  allow  an  ocular  inspection 


Hermaphrodism  and  Hypospadias.  133 

of  the  interior  of  the  rectum.     Unfortunatelj',  the  details 
of  this  very  rare  condition  are  incomplete." 

It  would  be  interesting  to  know  where  the  seat  of 
his  sexual  desire  is  situated,  unless  an  aching  testicle  is 
such.  I  once  knew  a  Spiritualist  who  claimed  to  feel 
the  pains  suffered  by  any  friends  with  whom  he  was  in 
S3' mpatliy ;  he  once  tried  to  argue  with  me  that  a  certain 
lady  patient — a  warm  personal  friend  of  my  questioner 
and  a  Spiritualist — had  ovaritis,  because  he  felt  an 
Intense  burning  pain  in  his  right  ovarian  region  when- 
ever he  went  near  to  her.  I  tried  to  reason  with  him 
that  that  pain  should  be  in  his  right  testicle,  but  he 
would  insist  on  having  the  sympathetic  pain  in  his 
ovarian  regrion. 


CHAPTER  XL 

Religio  Medici. 

Sir  Thomas  Browne,  in  his  "  Religio  Medici,"^  al- 
ludes to  the  scandal  that  is  generally  attached  to  our 
profession,  we  being  accused  of  professing  no  religion. 
That  this  opinion  is  still  prevalent  at  the  present  day  is 
undeniable, — philosophers  and  physicians  are  believed 
to  be  atheists  and  non-religionists, — while,  at  the  same 
time,  by  that  strange  contradiction  that  is  so  common, 
philosophers  and  physicians  are  tlie  known  and  recog- 
nized sources  of  religions,  such  is  the  intimate  relation 
existing  between  physical  and  moral  hygiene.  Confu- 
cius, the  contemporary  of  Pythagoras,  whose  religion 
was  said  to  be  nothing  more  than  the  observance  of  a 
certain  moral  and  political  ethical  code,  and  he  who  first 
formulated  the  text  "that  one  should  do  unto  others  as 
one  wislies  others  to  do  imto  him,"  the  founder  of  the 
Confucian  religion,  the  orthodox  religion  of  China,  was 
a  philosopher.  Buddha,  the  founder  of  the  second  creed 
recognized  in  China,  and  which  forms  the  religion  of  a 
great  pa*rt  of  eastern  Asia,  was  also  a  philosopher  who 
was  endeavoring  to  reduce  the  Brahminical  religion  to 
the  simple  principles  of  philosophical  religion,  based  on 
morality.  Moses  not  only  was  the  greatest  philosopher 
of  his  time,  but  also  had  an  insight  into  medicine  that 
to  us  of  the  present  day  is  simply  incomprehensible. 
The  Great  Master  was  both  a  philosopher  and  a  phy- 
sician, his  disputes  with  the  learned  and  his  attention  to 
the  sick  having  given  him  the  titles  of  Great  Master  and 
Divine  Henler. 
(134) 


Religio  Medici.  135 

To  use  the  words  of  the  "  Religio  Medici,"  the  great 
body  of  the  medical  profession  can,  without  usurpation, 
assume  the  name  of  Christians  ;  for  no  monk  of  the 
desert  convents  of  Asia  Minor  or  religious  knight  of 
the  middle  ages,  either  in  their  care  of  the  sick,  or  giv- 
ing food  and  shelter  to  the  weary,  or  protection  of  sword 
and  shield  to  the  oppressed  pilgrim  plodding  his  way  to 
the  Holy  Land,  were  more  deserving  of  the  name  of 
Christian  than  the  medical  man  unwearily  and  unself- 
ishly practicing  his  profession.  To  the  true  student  of 
his  art  there  is  that  in  medicine  which  makes  of  the 
physician  a  practical  Christian.  Nor  is  there  aught  in 
medicine,  either  in  its  traditions,  history,  study,  or 
practice,  that  in  the  lover  of  his  art  should  ever  make 
him  anything  but  a  philosophical  and  practical  religion- 
ist. The  physician,  such  as  is  activel}'  engaged  in  the 
daily  practice  of  his  profession,  instead  of  having  no 
religion,  is  really  a  practical  religionist,  and,  although  he 
may  subscribe  to  no  outer  ceremonial  form  or  dogma, 
his  life  is  such  that  a  Confucian,  a  Buddhist,  a  Christian, 
or  a  Hebrew  can  behold  in  him  the  practitioner  of  the 
essence  of  either  of  their  religious, — a  conception  car- 
I'ied  out  by  Lessing,  in  his  play  of  "  Nathau  the  Wise," 
where  the  Jew,  the  Saracen,  and  Crusader  teach  the 
impressive  lesson  that  nobleness  is  bound  by  no  confes- 
sion of  faith  or  religion ;  showing  the  principle  that 
should  guide  true  religion. 

The  Rev.  Dr.  Townsend,  of  Boston  Universit}^  has 
given  a  very  interesting  and  intelligent  relation  of  the 
connections  that  exist  between  medicine  and  the  Old 
Testament,  in  the  light  of  nineteenth-century  science.** 
The  article  in  question  is  interesting  in  its  logical 
reasons  as  to  whj^  the  Bible  was  inspired  by  a  superior 
power,  as  well  as  in  the  comparisons  it  lays  before  us 


136  Hidory  of  Circumcision. 

of  the  medicine  of  the  Pagans  and  that  of  the  Bible, 
during  the  early  history  of  the  world.  After  reviewing 
the  false,  crude,  and  senseless  vagaries  and  superstitious 
notions  that  passed  for  medicine  from  the  period  of  the 
Trojan  war,  in  1184  B.C.,  to  the  dissolution  of  the  Pytha- 
gorean Society,  500  B.C., — periods  which  existed  after 
the  writing  of  the  books  of  Moses, — and  the  period  be- 
tween 500  B.C.  and  320  B.C.,  or  the  philosophic  era  of 
medicine,  during  which  flourished  the  father  of  our 
present  system  of  medicine,  an  era  of  advancement,  but 
which  in  our  eyes  is  still  full  of  errors  and  unscien- 
tific conclusions.  Prom  these  two  periods  we  span  over 
centuries  of  darkness  for  science  and  medicine  to  the 
ages  of  Ambroise  Pare  and  the  more  modern  fathers  of 
our  art,  who  by  perseverance  finally  extricated  medicine 
from  the  mass  of  magical  and  superstitious  rubbish 
which,  like  barnacles,  had  clung  to  it  during  its  passage 
through  the  dark  and  ignorant  ages.  After  this  review 
our  author  turns  to  the  Bible  and  discourses  in  this 
wise: — 

*'  Turning  our  attention  to  the  Bible,  we  take  the  posi- 
tion that,  though  it  was  not  designed  to  teach  the  science 
of  medicine,  still,  whenever  by  hint,  explicit  statement, 
or  commandment  there  is  found  in  it  anything  relating 
to  medicine,  disease,  or  sanitary  regulation,  there  must 
be  no  error ;  that  is,  provided  the  Bible,  in  an  excep- 
tional sense,  is  God's  book.  Now,  what  are  the  facts  in 
this  case  ?  They  are  these :  though  the  Bible  often 
speaks  of  disease  and  remedy,  yet  the  illusions,  decep- 
tions, and  gross  errors  of  anatomy,  physiology,  and 
pathology,  as  formerly  taught,  nowhere  appear  upon 
its  pages.  This,  it  must  be  acknowledged,  is  at  least 
singular.  But  more  than  this  :  the  various  hints  and 
directions  of  the  Bible,  its   sanitary  regulations,  the 


Religio  Medici.  137 

isolation  of  the  sick,  tlie  washing,  the  sprinkling,  the 
external  applications,  and  the  various  moral  and  relig- 
ious injunctions  in  their  bearing  upon  health  are  con- 
fessed to  be  in  harmony  with  what  is  most  recent  and 
approved.  To  be  sure,  the  average  old-school  physician 
of  a  century  ago  would  have  blandly  smiled  at  our  sim- 
plicity^, had  it  been  suggested  to  him  that  his  methods 
would  be  improved  by  following  Bible  hints.  '  What 
did  Moses  know  about  medical  science?'  would  have 
been  his  reply.  But  Moses,  judged  by  recent  standards, 
seems  to  have  known  much,  or,  at  least,  to  have  written 
well." 

Tlie  above  statement  is  a  truthful  relation  of  facts, 
from  which  it  can  well  be  conceived  that  even  in  the 
Bible  the  physician  finds  something  to  inspire  him  with 
the  idea  of  its  divine  inspiration,  as  the  very  history  of 
medicine,  with  whicli  it  is  connected,  and  with  which  he 
is  familiar,  only  lends  him  further  support  in  that  direc- 
tion. Most  intelligent  physicians  are  also  lovers  of 
philosophical  histor3^  None  is  more  entertaining  than 
Rawlinson,  either  in  his  "  Seven  Great  Monarchies  "  or 
his  "Ancient  Egypt."  In  his  "Ancient  Religions,"  in 
his  concluding  remarks,  he  observes  as  follows,  in  re- 
gard to  the  Hebraic  religion  :  "  It  seems  impossible  to 
trace  back  to  any  one  fundamental  conception,  to  any 
innate  idea,  or  to  any  common  experience  or  observa- 
tion, the  various  religions  which  we  have  been  consider- 
ing. The  veiled  monotheism  of  Egypt,  the  dualism  of 
Persia,  the  shamanism  of  Etruria,  the  pronounced  poly- 
theism of  India  are  too  contrariant  to  admit  of  any  one 
explanation,  or  to  be  derivative  of  one  single  source. 
.  .  .  It  is  clear  that  from  none  of  the  religions  here 
treated  of  could  the  religion  of  the  ancient  Hebrews  have 
originated.     The  Israelite   people,  at  different  periods 


138  Hidory  of  Circumciaion. 

of  its  history,  came  and  remained  for  a  considerable 
time  under  Egyptian,  Babylonian,  and  Persian  influence, 
and  there  have  not  been  wanting  persons  of  ability 
who  have  regarded  Judaism  as  a  mere  offshoot  of  the 
religion  of  one  or  the  other  of  these  three  peoples.  But, 
with  the  knowledge  that  we  have  now  obtained  of  the 
religions  in  question,  such  views  have  been  regarded  as 
untenable,  if  not  henceforth  impossible.  Judaism  stands 
out  from  all  other  ancient  religions  as  a  thing  sui  generis, 
offering  the  sharpest  contrast  to  the  systems  prevalent 
in  the  rest. of  tlie  East,  and  so  entirely  difiierent  from 
them  in  its  essence  that  its  origin  could  not  but  have 
been  distinct  and  separate.  .  .  .  The  sacred  boolis 
of  the  Hebrews  cannot  possibly  have  been  derived  from 
the  sacred  writings  of  any  of  these  nations.  No  con- 
trast can  be  greater  than  that  between  the  Pentateuch 
and  the  '  Ritual  of  the  Dead,'  unless  it  be  that  between 
the  Pentateuch  and  the  Zendavesta,  or  between  the 
same  work  and  the  Vedas.  .  .  .In  most  religions 
the  monotheistic  idea  is  most  prominent  at  the  first,  and 
gradually  becomes  obscured,  and  gives  way  before  a 
polytheistic  corruption.  .  .  .  Altogether,  the  theory 
to  which  the  facts  appear  on  the  whole  to  point  is  the 
existence  of  a  primitive  religion,  communicated  to  man 
from  without,  whereof  monotheism  and  expiatory  sac- 
rifice were  parts,  and  the  gradual  clouding  over  of  this 
principle  everywhere,  unless  it  were  among  the  He- 
brews." ^^ 

Medicine  is  indebted  for  its  advancement  to  the 
Hebraic  religion  to  a  greater  extent  than  is  generally 
believed.  In  the  early  Christian  centuries  there  existed 
three  great  creeds  :  the  Christian,  Hebraic,  and  Moham- 
medan. The  Christian  Church  was  in  a  perplexing 
condition.     As  observed  by  Draper,'^  it  was  impossible 


Eeligio  Medici.  139 

to  disentangle  her  from  the  principles  which  had,  at  the 
beginning,  entered  into  her  political  organization.  For 
good  or  evil,  right  or  wrong,  her  necessity  required  that 
she  should  put  herself  forth  as  the  possessor  of  all 
knowledge  within  the  reach  of  the  human  intellect.  But 
the  monk  and  priest  were  prohibited  from  studying 
medicine,^'  as  by  so  doing  the  church  saw  that  she 
would  have  to  relinquish  the  spiritual  control  of  disease 
were  medicine  a  matter  of  scientific  research ;  she  pre- 
ferred to  hold  on  to  her  spiritual  dominion,  and  let 
science  slumber  in  darkness.  On  the  other  hand,  the 
Mohammedans,  recognizing  the  principle  of  fatalism  in 
their  religion,  it. was  not  to  be  expected  that  the}- should 
cultivate  an  art  entirely  opposed  to  that  principle.  In 
this  state  of  affairs  the  Jewish  physician,  led  by  the 
teachings  of  his  religion,  alone  presented  the  study  of 
medicine  in  a  scientific  manner,  and  its  practice  and  its 
result  taught  the  Moslems  that  medical  science  placed 
it  within  the  power  of  man  to  keep  himself  out  of  the 
grave,  when  either  assailed  by  disease  or  laid  low  by  the 
wounds  of  war.  The  Arabs  were  not  slow  to  avail 
themselves  of  this  discovery ;  and  to  the  learning  and 
skill  of  the  Jewish  physician,  guided  b}'  the  light  of  an 
intelligent  Deity  and  a  liberal  religion,  does  medicine 
owe  the  existence  of  those  able  and  learned  Arabian 
physicians  that  flourished  during  the  eleventh  and  twelfth 
centuries. 

There  has  been  more  or  less  of  fault-finding  in  regard 
to  certain  rules  and  ordinances  being  sacramental,  which, 
from  the  nature  of  things,  should  have  been  merely 
advisory  or  suggestive,  as  they  pertained  more  to  the 
liygienic  welfare  of  the  people  than  to  the  spiritual. 
Thus  to  reason,  is  neither  philosophical  nor  in  concert 
with  our  knowledge  of  the  structure  of  man,  and  of  the 


140  History  of  Circumcision. 

intimate  relations  that  exist  between  mind  and  body,  or 
of  good  health  and  good  morals.  The  writer  has  seen 
violent  catharsis  produced  b}^  bread  pills,  after  podophyl- 
lin,  castor-oil,  and  phosphate  of  soda  in  the  most  gener- 
ous doses — administered  as  one  would  drop  a  letter  in 
a  mail-box — had  completely  failed ;  it  is  all  in  the 
manner  and  way  we  give  a  medicine  or  treat  a  disease. 
Certain  narcotic  and  irritant  poisons  or  powerful  seda- 
tive agents  have  a  physical  action  uninfluenced  by  the 
mind,  but  an  intelligent  physician  is  hardly  supposed  to 
drive  at  the  small  tack  of  disease  with  such  powerful 
sledge-hammers.  Charcot,  recognizing  the  power  of 
and  availing  himself  of  such  a  remedial  agent  as  the 
pilgrimages  to  the  Notre  Dame  de  Lourdes,  is  an  evi- 
dence of  the  intelligent  and  enlightened  practitioner, 
who  has  learned,  what  the  Bible  taught,  long,  long  ago, 
that  human  nature  must  be  taken  as  it  is  found,  and  that, 
like  the  homely  saying  of  Mohammed,  as  the  mountain 
would  not  come  to  him,  he  must  go  to  the  mountain. 
Moses  and  all  the  Scriptural  writers  were  well  aware 
of  this  state  of  affairs,  and  their  manner  of  using  their 
knowledge  was  adapted  and  timed  to  the  general  intel- 
lectual development  of  the  times. 

There  is  one  point  in  connection  with  the  above  that 
should  not  escape  our  attention,  this  being  that,  while 
the  Hebraic  creed  and  the  people  still  subscribed  to  the 
theological  doctrine  of  the  origin  of  disease,  in  common 
with  the  religions  then  in  vogue,  here  the  connection 
stopped.  All  other  creeds — not  excepting  Christianit}-  — 
looked  forward  to  a  theological  doctrine  of  the  cure  of 
disease.  With  the  Hebrew,  disease  was  looked  upon  as 
the  result  of  some  infraction  on  his  part  of  some  of 
the  laws,  and  the  consequent  expression  of  displeasure 
on  the  part  of  the  Deity.     He  was  taught,  however, 


Religio  Medici.  141 

that  the  observance  of  certain  ordinances  were  both  con- 
ducive to  health  and  to  the  prevention  of  disease,  and 
acceptable  to  God,  as  well  as  to  rety  upon  his  study  and 
skill  to  cure  disease.  This  was  equivalent  to  teaching 
them  that  diseases  arose  from  physical  causes,  and  that 
physical  means  were  to  be  used  to  combat  them.  From 
this  arose  the  practice  of  exposing  the  sick  in  public 
places,  that  they  might  receive  the  benefit  of  the  advice 
of  such  who  might  have  had  experience  in  a  like  case. 
It  is  from  their  religion  that  Hebraic  medicine  has  re- 
ceived its  foundation  of  intelligent  philosophy  that 
carried  it  in  its  purity  through  all  ages,  free  from  magic, 
superstition,  and  imposture.  With  other  creeds  and 
religions,  medicine,  disease,  as  well  as  the  physical  phe- 
nomena affecting  nature,  were  believed  to  be  the  arbitrary 
expression  of  anger  of  their  gods,  and  that  the  cure  of 
disease,  or  alterations  in  physical  phenomena,  were  to  be 
as  arbitrarily  effected,  regardless  of  the  existence  or 
action  of  physical  laws.  It  is  to  be  regretted  that  one 
of  the  sects  which  has  sprung  from  the  Hebraic  creed, 
and  which  worships  the  same  God,  has  been  unable  to 
emancipate  itself  or  its  people  from  the  idea  of  an 
arbitrary  theological  doctrine  of  the  origin  and  control 
of  disease.  It  is  this  creation  of  a  narrow-minded 
theology  of  a  vaccilating,  unintelligent,  unphilosophical, 
and  arbitrary  God,  who  would  neither  respect  nor  regard 
the  laws  of  his  own  creation ,  that  has  led  the  great  body 
of  physicians  out  of  the  modern  churches.  They  do  not 
deny  the  existence  of  the  Deity,  but  the  god  of  their  con- 
ceptioji  is  a  higher  and  nobler  god, — the  Deity  of  Religio 
Medici. 

When  the  prize  for  the  best  essay  on  "  the  power, 
wisdom,  and  goodness  of  God,  as  manifested  in  creation^'' 
— a  series  of  publications   known  as  the   Bridgewater 


142  History  of  Circumcision. 

Treatises — has  been  nearly  every  other  time  won  by 
physicians,  among  whom  we  may  mention  Sir  Charles 
Bell,  Dr.  John  Kidd,  Dr.  Peter  M.  Roget,  and  Dr. 
William  Prout, — not  only  won  on  their  own  merit, 
bnt  in  competition  with  learned  theologians  and  noted 
divines,— we  may  truly  say  that  physicians  are  by  no 
means  atheists  or  agnostics,  but  that,  on  the  contrary, 
they  are  the  real  exponents  of  a  pi*aetical  and  intelligent 
religion,  which  they  not  onl}'^  practice,  but  fully  and  in- 
telligently comprehend. 


CHAPTER  XII. 
Hebraic  Circumcision. 

The  first  mention  that  we  meet  concerning  circum- 
cision is  in  Grenesis.  It  is  the  command  of  God  to 
Abraham;  in  establishing  the  covenant  with  him,  He 
said  to  him :  "  Tliis  is  my  covenant,  which  ye  shall  keep 
between  me  and  you,  and  thy  seed  after  thee :  every 
man-child  among  you  shall  be  circumcised.  And  ye 
shall  circumcise  the  flesh  of  your  foreskin ;  and  it  shall 
be  a  token  of  the  covenant  betwixt  me  and  you  "  (Gen. 
xvii,  10,  11).  It  was  also  ordained  that  this  should  be 
extended  to  servants  belonging  to  Abraham  and  his 
seed,  as  well  as  to  their  own  children  ;  and  that  in  case 
of  children  it  should  be  done  on  the  eighth  day  after 
birtli.^*  This  was  appointed  as  an  ordinance  of  perpetual 
obligation  on  the  Hebraic  family,  and  its  neglect  or 
omission  entailed  being  cut  off  from  the  people  (12, 14). 
In  compliance  with  this  ordinance,  Abraham,  although 
in  his  ninety-ninth  year,  circumcised  himself  and  all  his 
slaves,  as  well  as  his  son  Ishmael.  Slaves  by  purchase 
were  circumcised,^'  as  were  any  strangers,  who  were  also 
circumcised  before  being  allowed  to  partake  of  the  pass- 
over  or  to  become  Jewish  citizens.  It  was  to  be 
observed  by  all  heathens  who  became  converted  to  the 
Jewish  faith.  During  the  wanderings  in  the  wilderness 
circumcision  was  not  practiced,  but  Joshua  caused  all 
to  be  circumcised  before  they  entered  the  promised 
land.^^ 

The  old  Hebrews  strictly  followed  the  injunction  to 
circumcise  on  the  eighth  day,  and  of  such  importance  in 

(143) 


144  History  of  Circumcision. 

a  religious  sense  was  this  rite  in  tlieir  estimation  that 
CA'en  when  the  eighth  day  fell  on  the  Sabbath  the  eighth 
day  ordinance  was  observed.  The  ordinance,  however, 
was  not  blindly  arbitrary,  as  rules  were  laid  down  for 
exception.  For  instance,  whenever  a  family  had  lost 
two  children  through  circumcision  it  did  not  become 
obligatory  on  that  family  to  circumcise  the  third  child, 
who  was  however  considered  as  entitled  to  all  the  bene- 
fits of  the  congregation  or  of  the  Hebraic  religion,  just 
the  same  as  if  he  had  been  circumcised.  Again,  Mai- 
monides,  or  Moussa  Ben  Maimon,  a  celebrated  ph3^sician 
and  rabbi,  bom  in  Cordova  in  the  year  1135  a.d.,  among 
his  works  on  medicine,  has  left  directions  in  regard  to 
circumcision  which  have  been  the  guides  of  the  mohels. 
Among  the  Hebraic  physicians  it  was  considered  that 
the  child  partook  of  the  constitutional  strength  or 
feebleness  of  the  mother ;  hence  the  rule  above  men- 
tioned, in  regard  to  exemption  to  circumcision,  only 
was  in  operation  when  the  two  who  had  formerly  died 
belonged  to  the  same  mother  as  the  third  one,  who 
would  thereby  be  exempt ;  but  if  the  two  children  had 
belonged  to  another  woman,  and  this  third  child  of  the 
father  was  not  from  the  same  mother,  the  rule  did  not 
exempt.  The  third  child  of  the  mother  who  had  pre- 
viously lost  two  infants  at  the  rite  was,  however,  to  be 
circumcised  when  arrived  at  adult  age,  provided  no 
further  counter-indication  occurred.  The  opinion  that 
the  mother  gave  the  constitution  to  the  child  was 
promulgated  by  Maimonides  and  became  general. 

The  eighth  day  is  believed  to  refer  to  the  eighth  day 
after  full  term ;  thus,  a  child  born  prematurely  is  not 
supposed  to  be  circumcised  until  eight  days  after  it 
would  have  reached  its  full  term,  and  onl}'  then  if  its 
general  good  condition  is  settled.    Maimonides  looked 


Hebraic  Circumcision.  145 

upon  infantile  jaundice,  general  debility,  and  marasmus 
as  contra-indications  to  the  performance  of  the  rite  ;  any 
erysipelatous  inflammation,  ophthalmia,  anaemia,  erup- 
tion of  any  kind,  fever,  tendency  to  convulsive  move- 
ments— in  fact,  any  observable  departure  from  normal 
health  should  be  allowed  to  pass  before  performing  the 
rite.  Aside  from  these  general  conditions  that  denoted 
that  the  operation  was  contra-indicated,  tlie  local  con- 
dition of  the  organ  itself  also  was  to  be  examined,  aud 
if  certain  conditions  existed  the  operation  was  to  be  pat 
off.  These  conditions  consisted  in  any  irritation  or  red 
appearance  of  the  prepuce,  due  to  either  inflammation  or 
to  the  irritative  action  of  the  sebaceous  matter  undei'- 
neath  the  prepuce,  the  acrid  nature  of  these  secretions 
being  at  times  sufficientlj^  virulent  to  produce  an  ulcera- 
tion, even  in  the  newborn.^^ 

Among  the  Hebrews  themselves  there  arerthose  who 
do  not  look  upon  circumcision  in  a  favorable  light ^  but 
on  something  that  has  served  its  time  in  its  own  day, 
and  within  the  past  5'ear  a  prosel3'te  has  been  accepted 
into  one  of  the  New  York  synagogues  without  previous 
or  subsequent  circumcision,  these  reformed  Jews  look- 
ing upon  adult  circumcision  as  too  painful  an  operation 
to  be  gone  through,  as  the}'  claim,  unnecessarily.  It 
must  be  said,  however,  that  these  persons  look  upon 
circumcision  purelj'  in  a  sacramental  light,  and  simply 
as  an  arbitrary  ordinance  of  God  in  the  remote  ages  of 
antiquity,  but  which  in  the  present  century  has  not 
enough  practical  significance  to  warrant  its  performance 
on  the  occasion  of  an  adult  joining  the  congregation. 
These  persons  look  upon  it,  as  has  been  said,  in  a  purely 
theological  light,  and  ignore  any  and  all  considerations 
of  hygiene  in  connection  with  it,  claiming  that  if  it  is 
a  simple  matter  of  hygiene,  then  it  is  not  a  sacrament, 


146  History  of  Circumcision. 

and  that,  if  it  is  sacramental,  then  the  subject  of  hygi- 
ene has  notliing  whatever  to  do  with  it.  The  force 
of  their  reasoning  and  logic  is  very  obscure  and  clouded, 
to  saj'^  the  least.  The  covenant  either  exists  or  it  does 
not;  to  do  away  with  one  ordinance  in  any  arbitrary 
manner  is  to  gradually  begin  to  crumble  down  the  whole 
fabric  of  Judaism;  for  when  exceptions  are  begun,  one 
tenet  as  well  as  another  is  liable  to  topple  over.  If  the 
rite  is  a  sacrament,  then  it  should  be  performed  on  all, 
and  a  proselyte  should  not  be  admitted  without  being 
circumcised,  and,  if  a  h3^gienic  measure  onl3^,  the  same 
rule  holds.  These  Jews  evidently  ignore  the  rationalism 
that  governed  the  promulgation  of  the  Mosaic  law,  and 
its  recognition  of  the  inseparability  of  the  moral  from 
the  physical  natui'e  of  man. 

Montaigne  has  left  us  a  description  of  the  perform- 
ance of  the  rite,  as  witnessed  by  him  in  the  city  of  Rome 
in  the  sixteenth  century.  He  relates  it  as  follows  :  "  On 
tlie  thirtieth  of  January  was  witnessed  one  of  the  most 
ancient  ceremonies  of  religion  practiced  by  mankind, 
this  being  the  circumcision  of  the  Jews.  This  is  per- 
formed at  the  dwelling,  the  most  commodious  chamber 
being  chosen  for  the  occasion.  At  this  particular  time, 
by  reason  of  the  incommodity  of  the  house,  the  rite  was 
performed  at  the  door  of  the  domicile.  The  godfather 
sat  himself  on  a  table,  with  a  pillow  on  his  lap.  The 
godmother  then  brought  the  child,  after  which  she  re- 
tired. The  godfather  then  undressed  the  child's  lower 
part  so  as  to  expose  his  person,  while  the  operator  and 
his  assistant  began  to  chant  hymns.  This  operation  lasts 
at  least  a  quarter  of  an  hour.  The  operator  may  or  may 
not  be  a  rabbi,  as  it  is  considered  a  great  blessing  to 
perform  this  operation  ;  so  that  it  follows  that  man^'^  are 
found  who  are  anxious  to  exercise  their  faculty  in  this 


Hebraic  Circumcision.  147 

regard,  there  being  a  tradition  that  those  who  have  cir- 
cumcised a  certain  number  do  not  suffer  putrefaction  in 
their  mouth,  nor  does  their  mouth  become  food  for  worms 
after  death  ;  so  tliat  it  often  happens  that  they  make 
presents  of  value  to  the  chikl  for  the  privilege  of  oper- 
ating u})on  it.  On  the  same  table  on  which  the  godfather 
is  seated  all  the  required  instruments  and  apparatus  are 
placed,  while  an  assistant  stands  by  with  a  flask  of  wine 
and  a  glass.  A  warming-pan  full  of  coals  is  on  the  floor, 
at  which  tlie  operator  warms  his  hands.  The  child 
being  now  read}',  with  its  head  toward  the  godfather, 
the  operator,  seizing  the  member,  draws  the  foreskin 
toward  him  with  one  hand,  while  with  the  fingers  of  the 
other  he  pushes  back  the  glans ;  he  then  places  a  silver 
instrument,  which  fixes  the  skin,  and  which  at  the  same 
time  holds  back  the  glans  so  that  the  knife  may  not  cut 
it.  The  foreslcin  is  then  cut  off  and  buried  in  the  little 
basin  of  soil  that  forms  one  of  the  appurtenances  to  the 
operation.  The  operator  then  tears  with  his  nails  the 
skin  which  lies  on  the  glans,  which  he  turns  back  over 
the  body  of  the  member.  This  seems  the  hardest  and 
most  painful  part  of  the  operation,  which,  however, does 
not  seem  dangerous,  as  in  four  or  five  daj'S  tlie  wound 
has  healed.  The  crying  of  the  child  resembles  that  of 
an  infant  undergoing  baptism.  No  sooner  is  the  glans 
uncovered  than  the  operator  takes  a  mouthful  of  wine; 
he  then  places  the  glans  in  his  mouth  and  sucks  the 
blood  out  of  it;  this  he  repeats  three  times.  This  done, 
he  applies  a  powder  of  dragons'  blood,  with  which  he 
covers  up  all  the  wound,  the  parts  being  then  done  up 
in  expresslj'-cut  bandages.  He  is  then  given  a  glass  of 
win  over  which  he  says  some  prayers  ;  of  this  he  takes 
a  mouthful,  and,  after  moistening  his  fingers  in  the  same, 
he  applies  the  wine  three  times  to  the  child's  mouth. 


148  History  of  Circumcision. 

The  wine  is  tlien  sent  to  the  mother  and  the  women,  who 
are  in  some  other  apartment,  who  all  take  a  sip.  An 
assistant  then  takes  a  silver  instrument,  pierced  with 
little  holes  like  a  small  strainer,  which  he  first  applies 
to  the  nose  of  the  officiating  minister,  then  to  that  of 
the  child,  and  afterward  to  the  nose  of  the  godfather. "^^ 
The  above  description  of  the  performance  of  the  rite  in 
the  sixteenth  centiuy  answers  to  the  methotl  of  its  pei'- 
formance  as  was  witnessed  some  years  ago  in  France. 

In  the  "  Biblical,  Theological,  and  Ecclesiastical  C}'- 
clopaedia"  of  Drs.  McClintock  and  Strong  the  following 
description  of  the  rite,  as  taking  place  in  our  modern 
synagogues,  is  given  : — 

"The  cei'emon}'  of  circumcision,  as  practiced  by  the 
Jews  in  our  own  times,  is  thus  :  If  the  eighth  day  happens 
to  be  on  the  Sabbath,  the  ceremony  must  be  performed 
on  that  da}^,  notwithstanding  its  sanctity.  When  a  male 
child  is  born  the  godfather  is  chosen  from  amongst  Ms 
relatives  or  near  friends  ;  and  if  the  party  is  not  in  cir- 
cumstances to  bear  the  expenses,  which  are  considerable 
(for  after  the  ceremony  is  performed  a  breakfast  is  pro- 
vided, even  amongst  the  poor,  in  a  luxurious  manner), 
it  is  usual  for  the  poor  to  get  one  amongst  the  richer, 
who  accepts  the  office,  and  becomes  a  godfather.  There 
are  also  societies  formed  amongst  them  for  tlie  purpose 
of  defraying  the  expenses,  and  everj'  Jew  receives  the 
benefit  if  his  child  is  born  in  wedlock. 

"  The  ceremony  is  performed  in  the  following  man- 
ner, in  general :  The  circumciser  being  provided  with  a 
very  sharp  instrument  called  the  circumcising-knife, 
plasters,  cummin-seeds  to  dress  the  wound,  proper 
bandages,  etc.,  the  child  is  brought  to  the  door  of  the 
synagogue  by  the  godmother,  when  the  godfather  re- 
ceives it  from  her  and  carries  it  into  the  sj-uagogue, 


Hebraic  Circumcision.  149 

where  a  large  cliair  with  two  seats  is  placed  ;  the  one  is 
for  the  godfather  to  sit  upon,  the  other  is  called  the 
seat  of  Elijah  the  Prophet,  who  is  called  the  angel  or 
messenger  of  the  covenant.  As  soon  as  the  godfather 
enters  with  the  child,  the  congregation  say, '  Blessed  is 
he  that  cometh  to  be  circumcised,  and  enter  into  the 
covenant  on  the  eighth  da^'.'  The  godfather  being 
seated,  and  the  child  placed  on  a  cushion  in  his  lap,  the 
circumciser  performs  the  operation,  and,  holding  the 
child  in  his  arms,  takes  a  glass  of  wine  into  his  right 
hand,  and  says  as  follows  :  '  Blessed  be  Thou,  0  Lord 
our  God,  King  of  the  U^iiverse,  Creator  of  the  fruit  of 
the  vine  !  Blessed  art  Thou,  O  Lord  our  God !  who  hath 
sanctified  His  beloved  from,  the  womb,  and  ordained  an 
ordinance  for  His  kindred,  and  sealed  His  descendants 
with  the  mark  of  His  holy  covenant ;  therefore,  for  the 
merits  of  this,  O  living  God !  our  rock  and  inherit- 
ance, command  the  deliverance  of  the  beloved  of  our 
kindred  from  the  pit,  for  the  sake  of  the  .covenant 
which  He  hath  put  in  our  flesh.  Blessed  art  Thou,  O 
Lord,  the  Maker  of  the  Covenant  1  our  God,  and  the 
God  of  our  fathers !  Preserve  this  child  to  his  father 
and  mother,  and  his  name  shall  be  called  in  Israel,  A, 
the  son  of  B.  Let  the  father  rejoice  in  those  that  gb 
forth  from  his  loins,  and  let  his  mother  be  glad  in  the 
fruit  of  her  womb,  as  it  is  written  :  "  Thy  father  and 
mother  shall  rejoice,  and  they  that  begat  thee  shall  be 
glad." '  The  father  of  the  child  then  says  the  following 
grace  :  '  Blessed  art  Thou,  0  Lord  our  God,  King  of  tlie 
Universe  I  who  hath  sanctified  us  with  His  command- 
ments, and  commanded  us  to  enter  into  the  covenant  of 
our  holy  father,  Abraham.'  The  congregation  answer  : 
'  As  he  hath  entered  into  the  law,  the  canopy,  and  the 
good  and  virtuous  deeds,' "*^ 


CHAPTER  XIII. 

Mezizah,  the  Fourth  or  Objectionable  Act  of  Suction. 

Biblical  and  rabbinical  traditions  throw  no  light  on 
the  origin  of  the  details  of  the  operation  as  now  per- 
formed. That  it  was  anciently  performed  with  a  knife 
of  stone  is  certain  ;  an  event  common  in  its  general 
observance,  and  which  seems  to  have  pervaded  all 
nations  or  races,  howsoever  remote  or  scattered,  that  it 
has  induced  Tylor^**  to  ascribe  the  origin  of  the  rite  to 
the  stone  age.  We  are  told  that  when  Moses  wixH 
returning  to  the  land  of  Egypt  he  had  neglected 
circumcising  his  son,  and  that  because  of  that  neg- 
lect he  nearly  lost  his  son's  life;  his  wife,  Zipporah, 
the  daughter  of  tlie  Midian  king  and  priest,  Jethro, 
seeing  the  danger  and  knowing  its  cause,  took  her 
little  son  Gershom  and  circumcised  him  with  a  stone 
knife,  and  ottered  the  foreskin  to  God  as  a  peace-offer- 
ing. Just  where  tlie  wine  was  first  used  we  are  not 
told.  Wine,  however,  was  an  emblem  of  thanksgiving, 
and,  being  one  of  the  fruits  of  the  earth,  was  considered 
an  acceptable  offering  to  God.  It  has  since,  in  some 
form  or  other,  either  as  wine  or  as  the  representative  of 
either  divine  or  human  blood,  been  used  in  both  the 
Catholic  and  Protestant  Churches  in  their  ceremonials  or 
vicarious  sacrifices,  or  imitations  of  old  customs.  Cir- 
cumcision was  by  many  connected  with  a  blood  sacri- 
fice ;  it  was  so  suggested  by  the  words  of  Zipporah  at 
the  circumcision  of  Gershom  :  "  And  Zipporah,  his  Midi- 
anitish  wife,  took  up  a  sharp  stone  and  cut  off  the  fore- 
skin of  her  son,  and  cast  it  at  his  feet  and  said,  '  Surely 
(150) 


Mezizah,  Fourth  or  Objectionable  Act  of  Suction.     151 

a  Khathan  of  blood  art  thou  to  me.'  "  Much  specula- 
tion lias  followed  the  use  of  this  word  Khathan,  whicij, 
in  the  ordinary  Arabian,  may  mean  either  husband  or 
son-in-law  ;  it  also  means  a  newly-admitted  member  of 
a  family ;  a  similar  word  means  "  to  provide  a  wedding- 
feast,"  and  one  otlier  word  from  the  same  root  and 
branch  means  "  to  give  or  receive  a  daughter  in  mar- 
riage." In  our  own  day,  the  mohel,  or  ministerial  cir- 
cumciser,  makes  it  a  practice  to  draw  a  little  blood  from 
the  skin  of  such  as  are  presented  for  the  rite,  but  whom 
nature  has  not  furnished  with  sufficient  foreskin  for  tlie 
operation.  The  application,  thrice  repeated,  of  the 
blood  and  wine  to  the  lips  of  the  child,  is  probably  used 
as  a  sign  of  the  sealing  of  the  compact.  Wine  is  men- 
tioned in  connection  with  the  High-Priest  Melchisedeck 
as  the  wine  of  thanksgiving  at  his  meeting  with  Abra- 
ham ;  wine  was  presented  to  Aaron  by  the  angel,  who, 
giving  him  a  crystal  glassful  of  good  wine,  said  to  him  : 
"Aaron,  drink  of  this  wine  which  the  Lord  sends  you 
as  a  pledge  of  good  news."  Originally,  circumcision 
must  have  consisted  of  the  simple  removal  of  the  fore- 
skin, and  the  elaboration  of  the  ceremonial  details  must 
have  been  a  subsequent  occurrence;  persons  wounding 
their  fingers  will  instinctively  carry  them  to  their  mouth, 
and  it  may  be  that  the  suction  practiced  by  the  Hebrews 
had  its  origin  in  this  natural  haemostatic  suggestion. 
Wine  as  a  haemostatic  and  as  an  emblem  of  thanksgiv- 
ing and  an  acceptable  ofiering  naturally  came  in  as  an 
accessory. 

This  practice — which,  in  the  old,  patriarchal  days 
of  the  simple  shepherds,  when  men  only  lived  on  tlie 
flesh  of  their  own  flocks,  their  diet,  however,  consisting 
mostly  of  cakes  of  flour,  milk,  honej^,  a  few  herbs,  or 
the  flesh  of  the  goat  or  sheep — could  not  have  been  as 


152  History  of  Circumcision. 

objectionable  as  it  is  at  the  present  day,  with  blood  and 
secretions  in  a  continued  ferment "  through  diet  and 
habits.  Man,  living  in  the  open  air  of  Armenia,  Pales- 
tine, or  Arabia,  sleeping  in  the  open  tents  of  our  Bibli- 
cal forefathers,  living  on  the  simple  diet  of  a  shepherd's 
camp,  with  the  abstemiousness  that  those  climates 
naturall^^  induce  in  man,  could  not  help  but  be  healthy. 
In  those  early  days,  when  neither  passion,  anxiety,  nor 
worry  disturbed  either  digestion  or  sleep,  man  had  no 
vitiated  secretions,  wine  was  then  a  rarity,  and  water 
was  the  drink.  One  of  the  early  patriarchs  on  such 
diet  would  have  furnished  a  dainty  and  savorj^  dish  to 
the  most  fastidious  cannibal,  who  is  now  tormented  by 
the  komerhorg  kawan,  this  being  a  term  used  by  the 
Australian  cannibals  to  designate  the  peculiar  nausea 
that  is  induced  in  them  when  thej^  recklessly  eat  of 
white  man,^i — something  which  tiiey  do  not  experience 
from  feasting  on  the  savages  who  live  on  the  simple 
diet  of  a  pastoral  tribe.  This  primitive  gastronomic 
science  in  regard  to  cannibalism  even  reached  such  a 
pitch  of  refinement  that,  as  has  been  previously  men- 
tioned, some  tribes  even  I'esorted  to  emasculation  to 
improve  the  flavor  of  the  animal  juices,  which  by  this 
procedure  became  less  acrid.  The  Arabian  and  Oriental 
traditions  bring  us  down  tales  of  how,  on  the  same 
principles,  human  beings  intended  to  grace  the  festive 
platter  were  fed  exclusively  on  rice.  The  salivary'  and 
buccal  secretions,  under  such  a  simple  diet  as  that 
indulged  in  b}'  our  Biblical  forefathers,  become  bland 
and  harmless ;  not  only  harmless,  but  even  antiseptic 
and  positively  beneficial,  acting  on  the  same  principle 
as  local  applications  of  pepsin.  So  that  the  practice, 
at  the  time  of  the  patriarchs  and  in  their  own  family, 
of  this   part   of  the   rite   could   not   have  offered  the 


Mezizah,  Fourth  or  Objectionable  Act  of  Suction.     153 

same  objection  that  it  does  at  the  present  day.  The 
modern  house-dweller,  living  on  a  mixed  diet  and  in  a 
climate  that  induces  him  to  eat  grossh',  both  as  to 
quality  and  quantity,  partaking  more  or  less  of  vinous, 
spirituous,  or  fermented  liquors,  as  well  as  indulging  in 
tobacco,  is  quite  another  being  from  the  Arabian  or 
Armenian  shepherd  of  former  days.  Business  anxieties 
and  worrj'  also  have  a  very  pronounced  efl'ect ;  so  that, 
with  the  change  in  the  conditions  of  man  and  the  incep- 
tion and  multiplication  of  diseased  conditions,  as  well 
as  the  creation  of  constitutional  and  transmissible  dis- 
eases, this  practice  of  suction  should  have  been 
stopped. 

Intelligent  rabbis,  devoted  to  their  religion,  are 
necessarily  prone  to  defend  any  of  the  details  in  its 
ceremonials  that  age  and  practice  have  sanctioned,  and 
even  some  of  the  later  writings  of  Israelism  seem  to 
maTce  the  mezizah,  or  suction,  a  necessary  and  ceremonial 
detail  In  the  "  Guimara,"  composed  in  the  fifth  century, 
Rabbi  Rav  Pope  uses  these  words  :  "  All  operators  who 
fail  to  use  suction,  and  thereb}'  cause  the  infant  to  run 
an}^  risk,  should  be  destituted  of  the  right  to  perform 
the  ceremony."  In  the  "Mishna"  it  says,  "It  is  permitted 
on  the  Sabbath  to  do  all  that  is  necessary  to  perform 
circumcision,  excision,  deimdation,  and  suction."  The 
"Mishna"  was  composed  during  the  second  centur}'. 
The  celebrated  Maimojiides  lent  it  his  sanction,  as  in  his 
work  on  circumcision  he  advises  suction,  to  avoid  any 
subsequent  danger.  Our  modern  Israelites  are  sup- 
posed, as  a  rule,  to  have  taken  their  authority,  aside 
from  previous  usage  and  custom,  from  the  "  Beth  Yosef," 
w^hieli  was  written  by  Joseph  Karo,  and  subsequently 
annotated  by  the  Rabbi  Israel  Isserth.  In  all  of  these 
sanctions,  however,  there  is  no  reason  expressed  why  it 


154  History  of  Circumcision. 

should  be  performed .^^  Maimonides  undoubtedly  looked 
upon  this  act  as  having  a  decided  tendency  or  action  in 
depleting  the  immediate  A'essels  in  the  vicinity  of  the 
cut  surface,  and  that  the  consequent  constriction  in  their 
calibre  would  prevent  an}'  future  haemorrhage.  That 
this  is  the  natural  result  of  suction  is  a  fact  readilj^ 
understood  by  any  modern  physician.  Tlie  depletion 
of  the  vessel  for  some  distance  in  its  length,  -with  the 
contraction  in  the  coat  that  follows,  is  certainly  a  better 
preventive  to  consequent  hsemorrhage  than  the  simple 
application  of  any  styptic  preparation  that  can  only  be 
placed  at  the  mouth  of  the  vessel,  but  which  leaves  its 
calibre  intact.  Hot  water,  or  an  extreme  degree  of  cold, 
will  answer  to  produce  this  contraction  and  depletion, 
but  there  is  here  a  local  physical  reaction  that  is  more 
liable  to  occur  than  when  the  contraction  has  taken 
place  naturally,  as  when  induced  by  depletion,  instead 
of  by  the  stimulus  of  either  heat  or  cold.  So  that  if,  in 
the  light  of  modern  civilization  and  changed  conditions 
of  mankind,  and  the  existence  of  diseases -which  for- 
merly did  not  exist,  we  are  now  convinced  that  suction 
is  dangerous,  we  should  not  judge  the  ancients  too 
hastily  or  rashly  for  having  adopted  the  custom,  as  it  is 
certainly  not  without  some  scientific  merit ;  although,, 
authorities  are  not  wanting  who  hold  that  suction  or 
depletion  increases  the  danger  of  haemorrhage. 

It  can  be  understood  that  the  results  of  suction 
would  be  ill  some  measure  analogous  to  those  left  by 
the  application  of  an  Esmarch  bandage  on  a  limb.  The 
ancients,  performing  the  operation  with  rude  implements 
and  having  no  haemostatic  remedies  or  appliances,  natu- 
rall}^  followed  the  best  means  at  their  command  ;  tliey 
evidently  feared  haemorrhage,  and  their  rule  in  regard 
to  exemption  shows  us  that  they  recognized  the  exist- 


Mezizah,  Fourth  or  Objectionable  Act  of  Suction.     155 

ence  of  hsemori-liagic  diathesis  or  other  transmissible 
peculiarities  of  constitution.  This  same  fear  of  bsemor- 
rliage  probably  suggested  the  second  step  of  the  opera- 
tion being  performed,  as  it  is  by  laceration  instead  of 
b^'  cutting  instruments,  showing  in  this  an  evident  desire 
to  limit  the  cutting  part  of  the  operation  to  as  small  a 
limit  as  possible.  Against  an  infant  who  has  decided 
hsemorrhagic  tendency,  we  are  about  as  helpless  as  were 
the  ancient  Hebrews,  and,  while  the  Turkish  or  some 
of  the  Arabian  methods  of  performing  the  operation 
may  be  said  in  ordinar}^  cases — by  the  application  of 
cord  and  the  consequent  constriction — to  limit  the 
danger  from  subsequent  hgemorrhage,  still,  in  the 
haemorrhagic  diathesis  this  would  not  be  of  any  avail; 
so,  as  already  observed,  we  must  not  too  rashly  judge 
those  old  shepherds  of  the  Armenian  plains  for  adopt- 
ing a  practice  which  to  them  was  calculated  to  avert 
subsequent  dangers,  or  their  descendants  following  in 
their  footsteps,  until  having  learned  better,  even  if  that 
practice  is  to  us  disgusting,  primitive,  and  useless. 

Cases  occur, — happily  not  frequentl}',^ — of  alarming 
and  uncontrollable  haemorrhage.  The  following  case  is 
suggestive  of  the  alarming  extent  and  persistence  that 
may  attend  one  of  those  haemorrhagic  cases,  even  when 
recovery  eventually  takes  place.  It  is  reported  by  Dr. 
Sannanel  in  the  Gazetta  Toscana  delle  science  medicale 
e  fiaiche  of  1844.  The  case  was  that  of  a  Jewish  in- 
fant circumcised  on  the  eighth  day.  Some  hours  after 
the  operation  the  child  was  observed  to  be  bleeding ;  the 
haemorrhage  would  only  cease  for  a  few  moments,  and 
then  come  on  with  increased  force,  and  which  proved 
rebellious  to  ordinary  remedies.  Dr.  Sannanel  was 
called  during  the  night  of  the  third  day  after  the  opera- 
tion.    A  number  of  physicians  had  been  in  attendance, 


156  History  of  Circumcision. 

and  neither  ice,  astringents,  pressure,  nor  any  usual 
haemostatic  means  had  had  the  least  effect ;  cautery  with 
nitrate  of  silver,  sulphuric  acid,  and  the  actual  cautery 
by  means  of  heated  iron  were  tried  in  succession,  with- 
out any  good  results.  Ten  days  passed  in  this  manner, 
the  haemorrhage  only  ceasing  for  a  few  moments  at  a 
time,  and  the  child  was  nearly  exsanguinated  from  the 
continued  serous  seepage  and  the  paroxysmal  haemor- 
rliages,  when  a  lucky  application  of  caustic  j^otassa 
almost  immediately  stopped  the  haemorrhage.  This 
case  was  seen  by  nearly  all  the  leading  medical  men  of 
Leghorn,  who  lent  their  aid  and  counsel  to  saA^e  the 
little  life.  The  case  is  interesting  from  the  length  of 
time  it  persisted,  and  that  even  after  all  the  loss  of 
blood  and  suffering  that  the  little  fellow  endured  he 
survived.^' 

Dr.  Epstein,  of  Cincinnati,  in  a  letter  of  March  29, 
18*72,  to  the  Israelite  of  that  city,  mentions  a  nearly 
fatal  case  from  haemorrage  after  the  rite  of  "  3Iilah,^^ 
and  gives  the  result  of  his  experience  in  such  cases. 
He  argues  that  Hiiouch  or  Hitooch  alone,  or  the  first  step 
or  cutting  off  of  the  prepuce,  performed  with  ordinary 
care,  could  hardly  be  followed  up  with  any  more  serious 
results  thnn  can  be  controlled  with  the  application  of  a 
little  acidulated  water.  The  second  act,  or  Periah,  the 
act  of  laceration,  he  looks  upon  as  one  that  calls  for 
coolness,  judgment,  and  skill,  as  the  membrane  should 
only  be  torn  so  far  and  no  farther,  the  thin,  inner  fold 
of  the  prepuce  being  vascular  only  in  the  sulcus  back 
of  the  corona  and  at  its  lower  attachment,  where  it 
forms  the  frenum,  or  bridle;  any  carelessness  or  over- 
anxiety  on  the  part  of  the  operator  in  tearing  this  mem- 
brane too  far  back  results  in  danger  of  haemorrhage ; 
especially  is  this   part  of  the   operation   liable   to   be 


Mezizah,  Fourth  or  Ohjectionahle  Act  of  Suction.     157 

badly  done  if  the  inner  preputial  fold  is  thick  and  re- 
sisting, as  in  that  ease  undue  force  may  carry  the  lacera- 
tion back  into  the  vascular  tissue.  The  means  suggested 
by  Dr.  Epstein  to  an-est  haemorrhage  are  those  ordinarily 
used  in  haemorrhagic  cases,  such  as  will  be  given  pres- 
ently. The  doctor  regrets  that  the  operators  are  not 
as  they  should  be,  physicians,  and  that,  when  viohels  are 
employed,  persons  are  not  sufficiently  exacting  as  to 
their  qualifications.®* 

In  France  the  government  has  managed  to  secure 
more  safety  in  the  operation.  By  a  royal  decree  of  date 
of  May  25,  1845,  in  compliance  with  a  desire  expressed 
b}"^  the  Hebrew  Consistory,  it  was  ordered  that  no  one 
sihould  exercise  the  functions  of  a  mohel  or  of  schohet, 
without  being  duly  authorized  to  perform  said  functions 
by  the  Consistory  of  the  Circ3nscription;  and  that  all 
mohels  and  schohets  shall  be  governed  in  the  exercise  of 
their  functions  by  the  Departmental  Consistory  and  the 
General  Consistory.  By  virtue  of  this  decree  a  regula- 
tion was  passed  by  the  Consistories  on  the  12th  of  July^ 
1854,  ordering  that  thereafter  circumcision  should  only 
be  performed  in  a  rational  manner,  and  b}'^  a  properly 
qualified  person.  Suction  was  likewise  abolished,  and 
the  wound  directed  to  be  sponged  with  wine  and  water. 
This  decree  and  the  resulting  regulations  have  been  of 
the  greatest  benefit  to  the  French  Israelites,  and  some 
attention  to  the  matter  would  not  be  amiss  in  the  United 
States. 

This  reformation  has  met  with  the  approval  of  the 
leading  French  Jews,  whose  General  Consistory  decided 
that  suction  was  not  necessarily  a  part  of  the  religious 
rite,  and  that,  as  it  was  undoubtedlj'^  introduced  into  the 
rite  on  the  days  of  primitive  surgery,  it  was  perfectly 
rational    to    suppress    this  operative    accessory,  now 


158  History  of  Circumcision. 

that  that  same  science,  in  its  enlightenment,  pronounced 
it  unsafe.  The  whole  body  of  the  Congregation  did  not 
tnmely  submit  to  what  they  considered  an  innovation, 
and  from  some  of  the  mohels  all  possible  resistance  was 
opposed  to  prevent  the  abolishment  of  this  part  of  the 
operation  from  becoming  a  law.  So  determined  was 
this  opposition  in  some  instances  that  the  Consistor3'^  of 
Paris  found  it  necessary  to  impose  on  all  the  moiiels  an 
obligation,  bound  by  an  oath,  that  they  would  respect 
the  law.  Those  who  refused  to  take  the  obligation  gave 
up  their  vocation. 

The  Grand  Rabbi  of  Paris,  at  the  time  of  this 
reformation,  M.  Ennery,  was  one  of  the  most  zealous 
supporters  of  the  new  departure.  The  influence  of  the 
French  pervaded  northward,  and  the  mezizah  was  abol- 
ished in  Brunswick,  Dv*  Solomon,  a  learned  Hebrew 
of  that  State,  being  instrumental  in  having  it  done 
legally.  The  discussion  of  this  subject,  in  1845,  had 
one  very  happy  effect, — the  supporters  of  the  reformed 
idea  of  the  rite  issued  a  circular  letter  to  all  the  leading 
continental  surgeons  and  medical  men  asking  for  their 
opinion  on  several  points  in  relation  thereto,  especially, 
however,  on  this  part  of  the  rite.  The  opinions  of  many 
of  these  will  be  referred  to  in  the  medical  part  of  this 
work. 

The  after-treatment  of  the  circumcised  infant  is  gov- 
erned more  or  less  by  local  habits  and  the  individual 
intelligence  of  the  mohel  and  his  experience.  After 
turning  back  the  inner  fold  of  the  prepuce,  the  parts 
are  covered  with  a  small,  square  bandage,  with  an  aper- 
ture to  admit  the  passage  of  the  glans.  This,  and  the 
subsequent  small  bandage  of  old  linen,  which  is  calcu- 
lated to  hold  it  in  place,  are  slightly  coated  with  a 
powder    composed    of    lycopodium,    with    the    slight 


Mezizah,  Fourth  or  Objectionable  Act  of  Suction.     159 

addition,  at  times,  of  Monsel's  salts,  alum-powder,  or 
some  vegetable  astringent.  Over  these  another  compress 
is  placed,  to  prevent  the  friction  of  the  clothes  of  the 
infant  or  of  the  bedding.  The  infant  then  receives  a 
final  benediction,  and  the  godmother  then  receives  the 
child  in  her  arms  and  carries  it  to  its  cot  or  crib.  The 
operator  generally  visits  the  infant  in  the  afternoon  of 
the  operation,  and  carefully  inspects  the  dressings,  to 
see  that  no  haemorrhage  has  supervened. 

It  is  customary  to  place  the  child  in  a  bath,  either 
the  same  evening  or  on  the  following  morning,  the 
object  of  this  being  to  remove  and  to  facilitate  the 
removal  of  the  dressings,  which  are  more  or  less 
saturated  and  clotted  with  blood.  After  the  removal,  of 
these,  the  wound  is  redressed,  as  previousl3',  except 
that  some  cerate — ointment  of  roses  or  some  other 
mild  ointment — is  used.  Som€  prefer  the  simple  water 
dressing  from  beginning  to  end.  Since  the  introduction 
of  creasote,  acid  phenique,  and  carbolic  acid,  many 
mohels  are  in  the  practice  of  washing  the  parts  with 
water  impregnated  with  one  of  these  before  performing 
the  operation,  and  using  subsequently  the  same  form  of 
lotion  at  every  dressing.  In  case  of  haemorrhage  there 
is  an  haemostatic  water  or  lotion,  which  has  been  long 
used  by  the  German  and  Polish  mohels  with  consider- 
able success,  and  which,  in  ordinarj''  cases,  has  been 
found  to  be  all  that  was  required.  This  water,  called 
by  the  French  "  Mixture  d'arguesbusade,"  "  Eau  vul- 
neraire  spiriteuse  de  Theden,"  and  by  the  Germans  as 
*'  Spritzwasser  "   and  "  Schusswasser,"  is  composed  as 

follows : — 

Acetic  acid,   .         .        .         .        .10      grammes. 
Rectified  spirits  of  wine,       .        .      5  " 

Diluted  sulphuric  acid,  .        .      2}4  " 

Clarified  honey,     ....      8  " 

6 


160  History  of  Circumcision. 

This  mixture  is  well  mixed  and  filtered,  and  is  then 
kept  in  a  tiglitly-stoppered  vial. 

Dr.  Bergson  uses  a  mixture  composed  of  diluted 
sulphuric  acid,  1  part ;  alcohol,  3  parts  ;  hone}',  2  parts  ; 
and  6  parts  of  wine  vinegTar. 

Hemostatic  powders  are  also  used  by  the  Hebrews, 
being  more  conveniently  kept  or  carried  than  the 
hseraostatic  waters.  In  Russia  and  in  Poland  they  are 
composed  of  decomposed  or  decaj'ed  hawthorn-wood 
powder  and  13'copodium.  That  of  Berlin  is  composed 
of  Armenian  bole,  red  clay,  dragons'  blood,  powdered 
rose-leaves,  powdered  galls,  and  powdered  subcarbonate 
of  lead.  In  France  a  haemostatic  fluid,  composed  of 
dragons'  blood  digested  in  turpentine,  is  in  vogue. 
The  Eau  de  Pagliari  is  also  used  ;  it  is  composed  of 
a  mixture  of  tincture  of  benzoin,  8  ounces  ;  powdered 
alum,  1  pound  ;  and  10  pounds  of  water,  boiled  together 
for  six  hours,  and  is  considered  a  powerful  stj^ptic. 
In  addition  to  these,  burnt  linen,  spiders'  webs,  starch- 
powder,  powdered  alum,  and  plaster-of-Paris  powder  are 
used  by  different  mohels.  Touching  the  bleeding  points 
with  a  pointed  pencil  of  nitrate  of  silver  is  also  a  prac- 
tice understood  by  the  Jewish  circumcisers. 


CHAPTER  XIY. 
What  are  the  Benefits  of  Circumcision? 

There  are  those,  eA'en  among  the  Hebrews,  "wlio 
are  so  imbued  with  the  purelj^  tlieological  idea  of  the 
origin,  performance,  and  causes  of  circumcision,  that 
the^'  cannot  see  an}-  moral  nor  hj'gienic  value  in  the 
operation.  Among  many  Christians  the  idea  still  pre- 
A'ails  that  circumcision  is  the  relic  of  some  barbarous 
rite,  practiced  in  some  epoch  away  in  the  remote  ages 
of  the  world,  grafted  on  to  the  Jewish  religion  by  some 
accident  or  other;  but  that  beyond  the  clinging  of  the 
Jews  to  this  custom,  as  being  a  remnant  of  their  old  re- 
ligion, tliey  neitlier  see  in  the  rite  any  other  significance, 
moral  results,  nor  hj^gienic  precaution  ;  and  the  fact  of  a 
Jew  being  circumcised  is  too  often  made  a  subject  of 
merriment  among  the  unthinking  portion  of  the  Chris- 
tian world.  Neither  are  physicians  all  of  one  accord  on 
the  subject  as  to  whetlier  circumcision  is  a  benefit,  or, 
being  useless,  a  dangerous  and  an  unnecessary  opera- 
tion. The  writer  is  most  emphatically  in  favor  of  cir- 
cumcision, and  has  the  fullest  faith  in  the  positive 
moral  and  physical  benefits  that  mankind  gains  from  the 
operation. 

It  may  well  be  asked  :  What  does  the  Jew  receive 
in  return  for  all  the  suffering  that  he  inflicts  through  cir- 
cumcision on  himself  and  his  little  children  ?  What 
is  there  to  repa}^  him  or  his  for  all  the  risks  and  annoy- 
ances, besides  branding  himself  and  his  with  an 
indestructible  mark,  which  has  been  more  than  once  the 
sign  by  which  they  have  suffered  persecution,  spoliation, 

(161) 


162  History  of  Circumcision. 

expatriation,  and  death?  Are  there  any  benefits  en- 
joyed by  the  Jew  that  the  uncircumcised  does  not 
enjoj'  in  equal  proportion  ? 

The  relative  longevity  between  the  Hebrew  race  and 
the  Christian  nations  that  dwell  together  under  like 
climatic  and  political  conditions  indicates  a  stronger 
tenacity  on  the  part  of  the  Jewish  part  of  the  nations 
to  life,  a  greatly  less  liability  to  disease,  and  a  stronger 
resistance  to  epidemic,  endemic,  and  accidental  diseases. 
By  some  authorities  it  has  been  held  that  the  occupa- 
tions followed  by  the  Jew  are  such  as  do  not  compel 
him  to  risk  his  life,  as  he  neither  follows  any  labor  re- 
quiring any  great  and  continued  exertion,  nor  anj'  that 
subjects  him  to  any  great  exposure ;  that,  as  a  rule, 
when  in  business,  by  some  intuition  he  follows  some 
branch  that  has  neither  anxiety,  care,  nor  great  chance 
of  loss  connected  witli  it ;  that  he  does  not  follow  any 
occupation  that  is  attended  with  any  risk  of  accident 
for  either  life  or  limb.  Besides  all  these,  it  is  also  urged 
that  in  cities  the  careful  inspection  of  their  meat,  and  the 
peculiar  social  fabric  of  the  family,  the  love  and  venera- 
tion for  their  aged,  as  well  as  their  proverbial  charitj^to 
their  own  poor  and  sick,  and  their-provident  habits  and 
h3^gienic  regulations  imposed  upon  them  b}'  the  Mosaic 
law,  are  all  conditions  that  conspire  to  induce  longevit3^ 

That  the  Hebrew  is  generally  found  in  such  con- 
ditions as  above  described  is  undisputed ;  but  it  is 
questionable  if  all  these  conditions  are  necessarily  such 
as  are  favorable  to  health  and  long  life,  and  that, 
therefore,  the  longevity  of  the  Jewish  race  cannot 
altogether  be  ascribed  to  the  above  conditions.  Look- 
ing at  the  subject  of  occupation,  if  we  consult  Lombai-d, 
Thackrah,  and  the  later  works  on  the  effects  of  occupa- 
tion on  life,  we  must  admit  that  the  Jew  has  no  visible 


What  are  the  Benefits  of  CircumcUion'?         163 

advantage  in  that  regard,  as  he  follows  hardly  any  out- 
of-door  occupation,  being  often  in-doors  in  a  confined 
and  foul  atmospliere.  To  those  who  have  closely  ob- 
served the  race  in  this  country, — coming  as  they  do 
from  the  cold-wintered  climates  of  Germany,  Austria,  or 
Poland,  bringing  with  them  the  habit  of  living  in  small, 
close  rooms,  for  the  sake  of  economy  and  comfort, — it 
must  be  admitted  that  among  the  lower  classes  and  the 
poorer  of  the  race,  their  shops  being  connected,  as  they 
usually  are,  with  their  living-rooms,  the  toute  ensemble 
is  anything  but  conducive  to  a  long  life.  Their  an- 
aemic and  undeveloped  physical  condition  and  weak 
muscular  organization  are  sufficient  evidence  that  their 
surroundings  are  not  calculated  to  improve  health.  In 
England,  statistics  sufficiently  prove  that  the  fisherman 
on  the  coast,  exposed  to  all  kinds  of  weather,  is  not  as 
prone  to  disease  as  is  his  brother  Englishman  who  deals 
out  the  groceries  in  his  snug  shop.  Exercise  has  been 
held  an  important  element  in  the  factory  of  the  long- 
lived.  From  the  time  of  Hippocrates  down  to  Che^^ne, 
Rush,  Hufeland,  Tissot,  Charcot,  Humphry,  and  all 
authorities  on  the  factors  of  old  age,  exercise  has  been 
looked  upon  as  favoring  long  life.  Exercise  cannot  be 
said  to  enter  in  any  way  as  a  factor  in  the  longevity  of 
the  Jew;  but,  on  the  contrary,  his  in-door  life  is  known 
to  be  very  productive  of  phthisis  in  other  races.  His 
recreations  are,  as  a  rule,  of  the  home  social  order. 
They  visit  and  spend  the  time  allotted  to  recreation  in 
social  intercourse,  which  their  hospitality  always  insists 
on  accompanying  with  a  generous  lunch,  which,  to  say 
the  least,  is  not  an  element  that  is  conducive  to  either 
health  or  long  life  ;  for  no  people  excel  the  Jew  in 
home  hospitality,  and  even  among  the  poorer  classes  a 
stranger  is  never  allowed  to  depart  without  some  re- 


164  History  of  Circumcision.  , 

fresliment  being  offered  him.  Among  the  class  better 
able  to  extend  hospitality,  social  reunions  and  card 
parties,  with  lunches  of  fruits,  cakes,  cold  meats  and 
coffee,  or  wines,  are  among  their  regular  occurrences. 
Their  great  affection  for  the  familj'  and  for  their  youth 
and  aged  suggests  these  means  of  recreation,  as  then 
they  are  enjoyed  by  all  alike ;  but,  as  observed,  the 
hj^giene  of  all  this  is  very  doubtful ;  it  produces  too 
much  irregularity. 

It  is  related  that  after  the  Roman  conquest  of 
Palestine  many  of  the  Jews,  becoming  more  or  less 
accustomed  to  Roman  manners  and  customs,  often 
joined  in  the  games  which  the  Romans  held  in  imitation 
of  the  old  013'mpic  games  of  the  Grecians,  Not  to  be 
ridiculed,  many  resorted  to  the  practices  described  in  a 
previous  chapter,  to  efface  all  the  marks  of  their  cir- 
cumcision, that  they  might  enter  the  games  with  as 
much  freedom  as  the  Romans  or  other  uncircumcised 
nations ;  so  that  the  present  aversion  to  out-of-door 
sports  evinced  by  the  Jew  is  not  necessarily  a  racial 
trait ;  the  persecutions  and  political  inequality  that 
until  lately  he  has  been  made  to  suffer  have  driven 
him  into  retirement  and  seclusion.  Although  seeking 
neither  converts  nor  political  power  and  influence,  he 
has  been  hunted  down,  massacred,  and  chased  about  as 
a  dangerous  beast.  As  the  children  of  the  great  Rabbi 
Moses  Mendelssohn  asked  of  their  father :  "  Is  it  a 
disgrace  to  be  a  Jew  ?  Why  do  people  throw  stones  at 
us  and  call  us  names?"  It  may  well  be  asked,  why? 
These  actions  haA'^e  forced  them  into  the  social  and 
retired  habits  for  which  they  are  noted ;  altliough  it 
cannot  be  said  that  it  is  from  a  lack  of  spirit,  as  one  of 
the  Rothschilds  is  well  known  to  have  been  present  at 
tlie  battle  of  Waterloo,  where  from  a  spot  in  the  vicinity 


What  are  the  Benefits  of  Circumcision'}         165 

of  the  British  right-centre  he  observed  the  events  of 
the  battle;  and  when,  with  the  failure  of  Ney's  last  des- 
perate charge  with  the  formidable  battalions  of  the  Old 
Guard,  he  saw  the  advance  of  the  Prussians  closing  in 
on  the  French  right,  he  galloped  to  the  sea-shore,  and, 
crossing  the  Channel  in  a  frail  boat,  reached  London 
twentj'-four  hours  in  advance  of  the  news  of  the  battle,®^ 
but  long  enough  for  him  to  clear  several  millions  from 
off  the  panicky  state  of  the  money  market.  Marshal 
Massena,  one  of  Napoleon's  bravest  generals,  the  de- 
fender of  Genoa  and  the  hero  of  Wagram,  was  of 
Jewisli  origin. 

Athletic  sports  are  not  of  necessity  conducive  to 
long  life,  even  if  they  are  to  temporar3'  robust  health; 
but  there  is  no  mistaking  the  fact  that  the  sedentary 
and  in-door  life  of  the  average  Jew  is  a  deteriorator  to 
health  and  life,  and  especiall}'  among  that  class  of  fami- 
lies who  are  poor  and  keep  no  servant ;  from  heredity 
and  home  education  having  adopted  unhygienic  customs, 
in  which  they  have  grown  up, — in  these  a  total  disre- 
gard for  all  ventilation  forms  a  part.  Were  an  uncii'- 
cumcised  race  so  to  live,  scrofula  and  phthisis  would  be 
the  inevitable  result.  This  difference  of  results  I  have 
witnessed  more  than  once  as  existing  among  the  two 
races  coming  from  the  same  European  nationality, 
where  their  disregard  to  ordinary'  rules  of  hygiene,  in- 
duced b}^  climatic  canses,  especfally  A^entilation,  were 
alike  in  both  the  Semitic  and  European  descendants  of 
the  one  nation,  the  purely  European  being  more  prone 
to  consumption  and  scrofula.  It  is  interesting  to  note 
the  difference  in  the  moral,  mental,  and  physical  condi- 
tions induced  hj  creeds  ;  it  would  seem  as  if  it  should  not 
make  any  difference.  The  generally  accepted  idea  of 
religion  is  that  it  should  raise  the  moral  standai-d  of  all 


166  History  of  Circumcision. 

those  nations  Tvho  practice  religion ;  but  the  results  are 
very  peculiar,  as  we  are  forced  to  admit  that  reforma- 
tion in  religion  has  not  always  been  a  reformation  in 
morals.  Take  Great  Britain  for  example  ;  if  illegitimacy 
is  anj'  criterion  of  the  moral  state  of  those  professing 
creeds,  we  find  the  least  among  the  Jew ;  next  among 
the  Catholic  ;  next  comes  the  Episcopalian  ;  then  last 
the  Presbyterian. — the  oldest  creed  showing  the  great- 
est moral  tendency,  and  that  of  poor  Knox,  wliich  is 
the  youngest,  showing  the  least.  This  has  certainl}'  its 
phj'sical  effects,  that  are  not  without  its  influence  in 
producing  a  greater  or  lesser  length  of  life.  The 
eA'olutiou  of  religion  has  here  induced  a  lower  moral 
tone  and  a  resulting  ph^'sical  degeneracy. 

As  observed  by  alienists,  religions  of  different  creeds 
have  different  tendencies  in  inducing  insanity,  both  as  to 
ratio  of  population  and  as  to  manifestations;^  the 
Protestant,  when  unbalanced  b}'  religious  cause,  is  gen- 
erally controlled  with  some  idea  that  shows  itself  in  wild 
and  erratic  attempts  at  scriptural  interpretation,  caused 
b}-  want  of  fixed  dogmas  and  the  unending  splittings 
that  are  forever  taking  place  in  the  new  faith,  and  the 
persistent,  intrusive,  and  belligerent  spirit  of  proselytisra 
that  controls  each  new  brancli  as  it  buds  into  existence. 
The  Catholic  has  a  fixed  dogma, ^which  the  church 
attends  to,  and  be  neither  feels  called  upon  to  make  his 
neighbors  miserable  or  himself  insane  in  hunting  up  new 
interpretations.  When  he  does  go  insane  on  the  subject 
of  religion,  the  cause,  as  a  rule,  can  be  traced  to  some 
real  or  imagined  moral  delinqueuc3',  which  has  brought 
all  the  terrors  of  the  punishment  of  the  damned  forcibly 
and  persistently  to  his  disordered  imagination.  In  the 
insane-asylums  of  Cork,  in  Ireland,  with  its  overwhelm- 
ing Catholic  population,  the  ratio  of  inmates  in  regard  to 


What  are  the  Benefits  of  Circumcision'^         167 

creeds  is  as  that  of  one  Catliolic  to  ten  of  tlie  Refurmed 
religion,  showing  in  the  most  conclusive  manner  the  in- 
fluence exerted  by  religion  in  this  direction.  On  the 
other  hand,  the  Jew  has  the  simplest  of  religious  creeds; 
he  neither  wastes  useful  time,  robs  himself  of  sleep,  nor 
becomes  dyspeptic  in  hunting  for  hidden  meanings  in 
some  ambiguous  scriptural  phrase ;  he  is  satisfied  with 
his  creed,  his  dogmas  are  firmly  anchored,  and  the 
nature  of  his  religion  being  a  sort  of  famih*  congrega- 
tion, he  is  not  called  upon  to  go  out  in  search  of  prose- 
lytes, any  more  than  the  father  of  an  already  large 
family  feels  called  upon  to  go  out  and  hunt  up  the 
homeless,  that  he  may  convert  his  home  into  a  promis- 
cuous orphan-asylum.  As  before  remarked,  his  creed  is 
of  the  simplest,  and  there  exists  a  complete  and  explicit 
understanding  between  his  God  and  himself.  There  are 
no  m3'stical,  hidden  meanings  in  Scripture  for  the  Jew; 
nor  does  he  dread  any  eternal,  unheard-of,  and  inexplicable 
torments.  His  laws  are  very  clear,  and  the  punishments 
for  their  infraction  very  explicit.  To  the  Jew  it  is  a 
straight  and  well-lighted  road,  as  far  as  religion  is  con- 
cerned. The  writer  has  always  felt  that  it  took  a  mind 
that  was  incapable  of  appreciating  simple  truths,  but 
that  loved  to  hover  on  that  m3^stical  border-land  on  the 
confines  of  -gloom}-  insanit}*  that  would  allow  its  owner 
to  seriousl}^  wander  through  and  behold  any  theological 
beauties  in  Bunyan.  To  the  Jew  there  is  none  of  the 
gloomy,  weird,  mystical,  mind-racking,  ungodlj"  theology 
that  some  of  our  creeds  torture  the  poor  brains  of  their 
professors  with.  As  the  wild  Indian  of  the  plains  runs 
sticks  through  his  anatomy  and  capers  wildly  about  to 
torture  his  body,  so  some  of  the  creeds  delight  in  tort- 
uring their  devotees.  The  Jewish  religion  is  the  one 
best  suited  to  tranquilize  the  mind ;  it  is  very  philo- 


168  History  of  Circumcision. 

sophical  and  rational.  Were  he  to  acknowledge  Christ, 
he  would  not  have  to  change  his  ieourse  of  life  to  become 
a  most  exemplarN'  Christian.  The  celebrated  letter  of 
Moses  Mendelssohn  to  the  Swiss  clergyman,  Lavater,  in 
answer  to  a  dedication  of  the  latter  to  Mendelssohn,  is 
probably  the  best  exposition  of  the  essence  of  the  Jewish 
faith  that  can  be  found.  Therein  he  saj^s  :  "  We  be- 
lieve that  all  other  nations  of  the  earth  have  been  com- 
manded by  God  to  adhere  to  the  laws  of  nature.  Those 
who  regulate  their  conduct  according  to  this  religion  of 
nature  and  of  reason  are  called  virtuous  men  of  other 
nations,  and  are  the  children  of  eternal  salvation." 
Such  a  religion  does  not  unsettle  man's  mind. 

These  apparent  digressions  are  made  to  show  what 
additional  factors  exist,  besides  circumcision,  to  induce 
longevitj^  in  the  Jewish  race,  and  that  the  subject  may 
be  better  understood  ;  for  these  reasons  the  above  com- 
parisons have  been  made.  Students  of  demographic 
science  are  well  aware  that  form  of  government,  religion, 
climate,  diet,  habit,  and  custom, — all  have  an  important 
bearing  on  the  mental  and  physical  as  well  as  on  the 
moral  nature  of  man.  To  the  true  student  of  his  art  all 
these  conditions  are  but  factors  in  the  ph3'^3ical  scale,  and 
should  so  be  considered  without  fear  or  favor  ;  to  him  the 
whole  world  is  but  a  unit,  and  the  people  upon  its  sur- 
face are  but  as  one  people,  alike  subject  to  the  leveling 
laws  of  nature,  which  recognize  neither  royalty  nor 
vagrant,  nationality  nor  creed,  color,  condition,  nor 
station  in  life  or  society. 

Professor  Bernoulli,  of  Bale,  found  the  Israelite 
less  proliGc  than  the  Christian  f"^  subject  to  less  mor- 
tality, greater  longevit}',  less  still-born,  less  illegitimacy, 
less  crime  against  the  person,  and  less  insanity  and 
suicide,  when  compared  with   his  Christian  brother  — 


What  are  the  Benefits,  of  Circumcision?         169 

all  of  which  he  attributes  not  to  a  superior  ph3'sique  or 
organism,  but  solely  to  the  observance  of  the  laws  of 
their  religion  and  to  the  nature  of  tlie  same,  which  exer- 
cises a  beneficial  influence  on  the  mind. 

B.  W.  Richardson,  in  his  "  Diseases  of  Modern  Life," 
in  speaking  of  the  relation  of  race  to  disease,  says  : 
"  Through  the  valuable  labors  of  MM.  Legoyt,  Hoff- 
mann, Neufville,  and  Mayer,  we  have  obtained,  however, 
some  curious  facts  relative  to  the  most  widely  dissemi- 
nated of  all  races  on  the  earth,  the  Jewish.  These  facts 
show  that,  from  some  cause  or  causes,  this  race  presents 
an  endurance  against  disease  that  does  not  belong  to 
other  portions  of  the  civilized  communities  amongst 
which  its  members  dwell.  The  distinctness  of  the  Jews 
in  the  midst  of  other  and  mixed  races  singles  them  out 
specially  for  observation,  and  the  history  the^^  present 
of  vitality,  or,  in  other  words,  of  the  resistance  to  those 
influences  which  tend  to  shorten  the  natural  cycle  of 
life,  is  singularly  instructive. 

"  The  resistance  dates  from  the  fii'st  to  the  last 
periods  of  life.  Hoffmann  finds  that  in  Germany,  from. 
1823  to  1840,  tlie  number  of  still-born  among  the  Jews 
was  as  1  in  39,  while  with  other  races  it  was  1  in  40. 
Ma3'er  finds  that  in  Furth  children  from  one  to  five 
years  of  age  die  in  the  proportion  of  10  per  cent,  among 
the  Jewish,  and  14  per  cent,  among  the  Christian  popu- 
lation. M.  Neufville,  dealing  with  the  same  subject, 
from  the  statistics  of  Frankfurt,  gives  even  a  mox-e 
favorable  proportion  of  natality  to  the  Jewish  child 
population.  Continuing  his  estimates  from  the  ages 
named  into  riper  years,  the  value  of  life  is  still  in  favor 
of  the  Jews,  the  average  duration  of  the  life  of  the  Jew 
being  forty  years  and  nine  months  and  that  of  the 
Christian  being  thirtj^-six  years  and  eleven  months.     In 


no  History  of  GircumcAsion. 

the  total  of  all  ages,  the  half  of  the  Jews  born  reach  the 
age  of  fifty-three  years  and  one  month,  whilst  half  of 
the  Christians  born  only  reach  the  age  of  thirty-six 
years.  A  quarter  of  the  Jewish  population  born  is 
found  living  beyond  seventy-one  years,  but  a  quarter  of 
the  Christian  population  is  found  living  be3^ond  fifty- 
nine  years  and  ten  mouths  onl3\  The  Civil  State 
extracts  of  Prussia  give  to  the  Jews  a  mortality  of  1.61 
per  cent. ;  to  the  whole  kingdom,  2.62  per  cent.  To  the 
Jews  they  give  an  annual  increase  of  1.73  per  cent.;  to 
the  Cliristian,  1.36  per  cent.  The  effective  of  the  Jews 
require  a  period  of  forty-one  3'ears  and  a  half  to  double 
themselves ;  those  of  other  races,  fiftj^-one  years.  In 
1849,  Prussia  returned  one  death  for  every  fortj'-one  of 
the  Jews  and  one  for  every  thirty-two  of  the  remaining 
population, 

"  The  Jews  escaped  the  great  epidemics  more  readily 
than  the  other  races  with  whom  they  lived.  Thus,  the 
mortality  from  cholera  amongst  them  is  so  small  that 
the  very  fact  of  its  occurrence  has  been  disputed. 
Lastl}^,  that  element  of  mortality,  suicide,  which  we  may 
look  upon  philosophically  as  a  phenomenon  of  disease, 
is  comi)uted  by  Clatter,  from  a  proportion  of  one  million 
of  inhabitants  of  Prussia,  Bavaria,  Wiirtemburg,  Aus- 
tria, Hungar}^,  and  Tranyslvania,  to  have  been  com- 
mitted by  rather  less  than  one  of  the  Jewish  race  to 
four  of  the  members  of  the  mixed  races  of  the  Christian 
population.  Different  causes  have  been  assigned  for 
this  higher  vitality  of  the  Jewish  race,  and  it  were 
indeed  wise  to  seek  for  the  causes,  since  that  race  which 
presents  the  strongest  vitality,  the  greatest  increase  of 
life,  and  the  longest  resistance  to  death  must  in  course 
of  time  become,  under  the  influences  of  civilization, 
dominant.     We  see  this  truth,  indeed,  actually'  exempli- 


What  are  the  Benefits  of  Circumcision  ?         171 

fied  in  the  Jews  ;  for  no  other  known  race  has  ever 
endured  ,so  much  or  resisted  so  much.  Persecuted, 
oppressed  by  every  imaginable  form  of  tyranny,  they 
have  held  together  and  lived,  carr3'ing  on  intact  their 
customs,  their  beliefs,  their  faith,  for  centuries,  until,  set 
free  at  last,  they  flourish  as  if  endowed  with  new  force. 
They  rule  more  potently  than  ever,  far  more  potently 
than  when  Solomon  in  all  his  glory  reigned  in  Jerusalem. 
They  rule,  and  neither  fight  nor  waste. "^^ 

Richardson  attributes  the  great  benefits  enjoj'ed  in 
this  regard  b}-  the  Jewish  race  to  the  soberness  of  their 
lives.  This  position  is,  however,  not  altogether  tenable, 
if  by  that  we  mean  abstemiousness ;  they  are  extremely 
temperate, but  not  abstemious.  Tissot,  Cornaro,  Lessius, 
Hufeland,  Humphry,  Sir  Henry  Thompson,  as  well  as 
the  older  Greek  and  Roman  authorities,  all  are  agreed 
that  an  abstemious  life  is  the  one  that  is  most  conducive 
to  long  life.  There  is  no  race  that  is  more  proverbial 
for  their  good  cheer  and  indulgence  in  the  good  things 
of  the  table  than  the  Jewish  ;  no  race  enjoys  feasting 
any  more  than  they,  and  from  childhood  the}'  are  accus- 
tomed to  a  generous  and  nutritious  diet,  as  well  as  to 
their  share  of  the  wines  with  which  their  tables  are  sup- 
plied. Their  greater  thrift  and  application  to  business, 
their  habits  of  economy  and  carefulness  in  business 
affairs  enable  them  to  better  supply  their  tables.  In 
California  there  is  no  class  that  lives  better  or  whose 
tables  are  supplied  so  well  either  as  to  qnalit}^  or  quan- 
tity as  those  of  the  Jews,  and  yet  no  class  is  more 
exempt  than  they  from  the  class  of  diseases  that  origi- 
nate in  too  good  living.  As  before  remarked,  in  relation 
to  the  poor  of  that  faith,  who  are  unable  to  keep  a 
servant,  and  who  live  in  a  combination  of  shop  and  home 
in  the  most  unhygienic  condition,  disregarding  ventila- 


172  History  of  Circumcision. 

tion  and  eveiy  other  sanitary  needs,  but  who,  neverthe- 
less, escape  the  evil  results  that  would  and  do  attend 
such  social  conditions  among  those  of  other  races,  so  in 
this  instance  of  good  living  :  the  better  class  of  Jews  do 
not  suffer  in  anything  near  a  like  proportion  to  the  better 
class  Christians  from  diseases  incident  to  too  full  habits 
and  an  inactive  life.  Richardson  observes  that  he  drinks 
less  and  that  he  eats  better  food  than  his  Christian 
brother.  In  regard  to  the  drinking  habit,  overindul- 
gence is  not  a  Jewish  failing ;  they  do  not  drink,  to 
excess,  but  total  abstinence  is  not  in  their  vocabulary. 
It  is  inconsistent  with  their  idea  of  wine  as  being  a  gift 
of  God,  and  something  that  is  s^ymbolical  of  good  faith 
and  thanksgiving.  Nor  is  total  abstinence  consistent 
with  their  idea  of  generous  hospitality.  On  the  eighth 
day  after  birth  the  Jew  tastes  wine,  and  from  the  time 
he  is  able  to  sit  at  table  he  becomes  familiar  with  its  use. 
To  him  wine  is  not  symbolical  of  either  moral  depravit}', 
mental  or  phjsical  deterioration,  or  of  death.  Their 
females  are  all  accustomed  to  its  use  from  childhood, 
but  it  does  not  cause  them  to  become  either  immoral  or 
unchaste  ;  so  that  in  neither  sex  does  wine  produce  that 
moral  and  mental  wreckage  which  abbreviates  the  length 
of  human  existence  among  those  of  other  creeds. 
Radical  fanaticism,  that  drives  a  tack  with  a  maul  and  a 
twenty-penny  spike  with  a  tack-hammer,  cannot  be  ex- 
pected to  study  this  or  an}'  other  question  in  an}^  rational 
manner ;  but  to  the  sociologist,  the  question  as  to  what 
produces  this  remarkable  soberness,  in  the  midst  of  the 
habitual  and  continued  use  of  wine  in  the  race  from  the 
time  of  its  earliest  history,  is  something  worth}^  of  calm 
and  careful  consideration.  How  much  circumcision  may 
have  to  do  with  this  will  be  discussed  in  the  medical 
part  of  the  volume. 


What  are  the  Benefits  of  Circumcision'?         173 

In  London,  according  to  Dr.  Stallard,  the  mortality 
among  Jewish  children  from  one  to  five  years  is  only  ten 
per  cent.,  while  among  the  children  of  the  Christians  it 
is  fourteen  per  cent.,  the  rate  being  analogous  to  that 
observed  by  Ma3^er  among  those  of  these  ages  in  Furth. 
Among  the  London  adults  the  average  duration  of  life 
among  the  Jews  is  forty- seven  j^ears,  while  among  the 
Christians  it  is  only  thirty-seven. 

Dr.  Hough^^  has  gatliered  some  interesting  historical 
and  statistical  matter  bearing  on  the  subject  of  Jewish 
resistance  to  disease  and  the  benefit  possessed  by  the 
race  in  relation  to  the  immunity  enjoyed  by  them  in 
prevailing  epidemics.  The  plague  of  1346  did  not  affect 
them  ;  according  to  Fracastor  the}^  escaped  the  typhus 
of  1505;  Rau  remarks  their  immunity  to  the  typhus  of 
1824 ;  Ramazzini  noticed  their  exemption  to  the  fatal 
iutermittents  of  Rome,  in  1691  ;  and  Degner  saj^s  that 
they  escaped  the  epidemic  dysentery  at  Nimegue,  in 
1736.  Richardson  truly  observes  that  "  from  epidemics 
the  Jews  have  often  escaped,  as  if  they  possessed  a 
charmed  life."  This  racial  difference  and  benefit,  when 
compared  to  other  races,  has  more  than  once  cost  them 
dear.  In  the  dark  and  ignorant  ages,  when  men 
reasoned  nothing  from  a  physical  basis,  but  attributed 
all  and  every  phenomena  to  some  supernatural  agency, 
either  heavenl}^  or  diabolical,  it  was  but  natural  for  such 
minds  to  associate  this  exemption  with  some  purchased 
compact  made  with  the  devil,  who  was  often  also  held 
accountable  for  tlie  existence  of  the  epidemics.  The 
rational  and  law-of-nature  observing  Jew  supposed  to  be 
in  league  with  his  satanic  majesty  could  neither  be  seen 
nor  heard  in  his  own  defense  ;  consequentily,  massacres, 
pillaging,  and  such  other  barbarities  that  an  insane 
popular  fury  could  suggest,  were  the  humane  manifesta- 


174  History  of  Circumcision. 

tions  with  which  a  Christian  people  visited  their  Jewish 
brothers,  whose  only  sin  consisted  in  worshiping  the 
God  of  their  fathers,  and  in  strictly  observing  His  laws 
and  commandments. 

In  France,  Dr.  Neufville  found  that,  of  one  hundred 
children  in  the  first  five  years  of  life,  among  the  Jewish 
population,  12.9  die;  while  from  the  same  number  of 
tlie  same  aged  class  of  Christians  24.1  die.  One-half 
of  all  the  Christians  die  at  thirt3'-six  years,  and  one-half 
of  all  the  Jews  at  fifty-three  3'ears  and  one  month. 

Dr.  John  S.  Billings  has  gathered  statistics  relating 
to  10,618  Jewisli  families,  consisting  of  60,630  persons,^" 
living  in  the  United  States  in  December,  1889,  mostly 
descendants  of  Jews  from  the  northern  or  middle  nations 
of  Europe.  For  our  purpose  only  the  deductions  as  to 
death-rate  and  tendency  to  longevity  will  be  given.  In 
this  valuable  paper  Dr.  Billings  says  :  "  When  we  come 
to  examine  the  reports  of  deaths  for  five  years  furnished 
by  these  Jewish  families,  we  find  that  they  give  an  aver- 
age annual  denth-rate  of  only  7.1  per  1000,  which  would 
be  about  one-half  of  the  annual  death-rate  among  other 
persons  of  the  same  average  social  class  and  condition 
living  in  this  countr3^"  To  this  he  adds  that,  provided 
the  deaths  at  different  ages  among  the  Jews  have  been 
correctly  reported,  this  race  will,  on  comparison  witli 
those  of  other  races,  show  a  greater  tendency  to  lon- 
gevit}',  as  the  Jewish  expectation  of  life  is  at  each  age 
markedly  greater  than  that  of  the  class  of  people  who 
insure  their  lives,  the  average  excess  being  a  little  over 
twent^'^  per  cent. 

In  speaking  of  the  death-rate  among  children,  Dr. 
Billings  makes  the  following  comparisons  :  "  The  low 
death-rate  among  the  Jews  is  especiall}'  marked  among 
the  children,  and  this  corresponds  to  European  experi- 


What  are  the  Benefits  of  Circumcision  ?        175 

ence.  Thus  in  Prussia,  in  1887,  tlie  death-rate  of  the 
Jews  under  fifteen  j^ears  of  age  was  5.63  for  1000,  while 
among  the  remainder  of  the  people  it  was  10.46  per 
1000."  This  result  he  accounts  for  partly  to  the  fact 
that  among  the  Jews  illegitimac}'  is  comparatively  rare 
and  to  the  high  rate  of  mortalitj^  among  the  illegitimate 
born,  which  raises  the  average  of  the  other  classes. 

In  regard  to  the  immunity  of  the  race  from  consump- 
tion or  tubercular  disease,  the  statistics  of  the  above 
Jewish  families  gives  to  the  Jews  less  than  one-third  of 
the  number  of  deaths  from  these  diseases  than  what 
occurs  among  the  others  as  to  the  male  population,  and 
less  than  one-fourth  as  to  the  female  population.  These 
statistics  coincide  with  the  observations  of  the  writer  on 
this  part  of  the  subject,  and  are  even  more  than  corrobo- 
rated by  the  French  War-Office  Reports  from  Algeria, 
where  the  deaths  from  consumption  among  the  Chris- 
tians amount  to  1  for  each  9.3  deaths,  and.  among  the 
Jews  to  1  in  36.9,  while  among  the  Mohammedans  it  is 
only  1  in  40.7  deaths.  In  Algeria  the  relative  mortality 
from  all  causes  is  only  about  three-fifths  of  that  of  the 
Christian,  and  the  Turk,  although  seeming  to  enjoy  a 
greater  exemption  from  phthisical  or  tubercular  diseases 
than  the  Jew,  falls  below  the  Jew  in  exemption  from 
deaths  due  to  general  causes,  as  his  mortalit}^  is  one- 
eighth  greater  than  that  of  the  Jew.  Dr.  Billings  gives 
us  some  interesting  food  for  thought  in  the  course  of  his 
article  and  some  more  particularly  bearing  on  the  sub- 
ject of  immunity  from  consumption.  He  asks:  "Are 
these  differences  due  to  race  characteristics,  properly 
so-called,  to  original  and  inherited  differences  in  bodily 
organization,  or  are  they,  rather,  to  be  attributed  to  the 
customs,  habits,  and  modes  of  life  of  the  two  classes  of 
people?" 


176  History  of  Circumcision. 

Some  years  ago,  Henry  I.  Bowditch,  of  Boston,  put 
on  foot  an  extended  sj^stem  of  inquiry  in  regard  to 
ascertaining  the  causes  or  antecedents  of  consumptioii 
in  the  State  of  Massachusetts.  In  answer  to  some  of 
the  questions  of  the  circular,  Rabbi  Dr.  Guinzburg,  of 
Boston,  answered  as  follows,  under  date  of  October  29, 
1872:— 

1st.  The  number  of  Jews  living  in  Boston  is  about 
5000. 

2d.  There  certainly  have  not  died  of  consumption, 
during  the  last  five  years,  more  than  eight  or  ten  Jews 
in  the  various  congregations. 

To  this  Dr.  Bowditch  adds,  as  follows  : — 

"  If  Dr.  Guinzburg's  data  be  correct,  they  show  a 
ver}'^  great  immunity  from  consumption  on  the  part  of 
the  Jews,  compared  with  the  citizens  generally,  as  will 
be  seen  b^'  the  following  comparison  between  these 
numbers  and  those  procured  from  the  Registration 
Reports,  published  by  the  State.  In  the  report  pub- 
lished in  1869,  page  64,  we  find  that  for  the  five  years  pre- 
ceding 1869  the  annual  average  of  deaths  by  consump- 
tion was  338  for  every  100,000  living.  These  data  from 
Dr.  Guinzburg  and  the  State  Report  give  the  following 
table  : — 

Proportion  of  Deaths  to 
100,000  of  Living. 

All  religions, 338 

Jews, 40 

"  These  statements  from  Dr.  Guinzburg  are  confirmed 
by  the  following  letter  from  Dr.  A.  Haskins,  of  this  city. 
Dr.  Haskins  is  connected  with  one  of  the  Jewish  benev- 
olent associations  for  the  benefit  of  the  sick.  I  sent  to 
him  similar  questions  and  make  the  following  extracts 
from  his  repl}^ : — 

'"I  am  generally  em ploj'ed  in  about  sixtj^  families 


What  are  the  Benefits  of  Circumcision'^ 
\^      T  hn.vp  hnrl  thpsp   fnTnilif'S  niider  mv  f 


177 


(Jewish).  I  have  had  these  families  under  1113'  care  for 
two  and  a  half  years.  During  this  time  I  have  seen  but 
one  case  of  consumption.  I  haA^e  averaged  among  these 
sixty  families  about  two  visits  daily.  In  m}'  other  Jewish 
practice,  which  is  not  inconsiderable,!  have  in  this  time 
(two  and  a  half  3'ears)  seen  two  cases  of  consumption. 
.  .  .  I  am  sorry  I  have  no  statistics  wherebj'  I  could 
compare  the  two  peoples,  viz.,  Jews  and  Christians.  I 
can,  therefore,  give  you  only  my  impressions.  I  should 
say  that  I  find  consumption  less  frequent  among  the 
Jews  than  among  Christians.  This  would  be  my  own 
impression  without  an}-  data  to  fortify  it.' 

"  Dr.  Waterman  also  sustains  the  same  idea.  The  fol- 
lowing extract  will  give  some  idea  of  his  opportunities 
for  observation  and  the  sources  of  his  deductions  : — 

'"  Boston,  November  2,  1872.  Dear  Sir, — .  .  .  . 
First,  I  have  attended  four  charitable  associations ; 
number  about  fort}',  fift}",  sixty,  and  one  hundred  fami- 
lies. At  present  I  only  attend  one,  containing  one  hun- 
dred families,  and  on  which  I  average  a  fraction  over  one 
visit  a  daj^  I  have,  besides,  many  private  families  among 
the  Jews.  I  have  attended  but  few  cases  of  consumption, 
and  I  think  the  disease  is  not  so  prevalent  as  among 
Christians.' " 

The  same  report  of  Dr.  Bowditch  quotes  from  Stal- 
lard's  "  London  Pauperism  Amongst  Jews  and  Chris- 
tians," as  saying  that  there  is  no  hereditary  sj'philis, 
and  scarcely  any  scrofula  to  augment  the  mortality  in 
the  Jewish  families. 

In  relation  to  the  liability  of  the  Hebrew  race  to 
phthisis,  Richardson  has  the  following  at  page  22  of  his 
"  Diseases  of  Modern  Life":  "The  special  inroads  on 
vitality  made  on  other  races  by  disease  are  not  easily 
determined,  because  of  the  difficulties  arising-  from  tem- 


178  History  of  Circumcision. 

porary  admixture  of  race.  I  tried  once  to  elicit  some 
fiicts  from  a  large  experience  of  a  particular  disease, 
phthisis  pulmonalis,  and,  as  the  results  of  this  attempt 
may  l»e  useful,  I  put  them  briefl}'  on  record. 

"At  a  public  institution  at  which  large  numbers  of 
persons  afflicted  with  chest  diseases  applied  for  medical 
assistance,  and  at  which  I  was  for  many  j-ears  one  of  the 
phj'sicians,  I  made  notes  during  a  short  portion  of  the 
time  of  the  connection  that  existed  between  race  and  the 
particular  disease  I  have  instanced — phthisis  pulmonalis, 
or  pulmonar^^  consumption.  The  number  of  persons 
observed  under  the  disease  was  three  hundred,  and  no 
person  was  put  on  the  record  who  was  not  suffering 
from  a  malady'  pure  and  simple ;  I  mean  without  com- 
plication with  any  other  malad3^  They  who  were  thus 
studied  were  of  four  classes  :  (a)  those  who  were  hy  race 
distinctl}'  Saxon  ;  (b)  those  who  w^ere  of  mixed  race,  or 
whose  race  could  not  be  determined  ;  (c)  those  who  were 
distinctly  Celtic  ;  (d)  those  who  were  distinctly  Jewish. 

"  The  results  were,  that  of  the  three  hundred 
patients,  one  hundred  and  thirt3' -three,  44  33  per  cent., 
were  Saxon  ;  one  hundred  and  eighteen,  39.33  per  cent., 
were  of  mixed  or  undetermined  race ;  thirty-one,  10.33 
per  cent.,  were  Celtic;  and  eighteen,  6  per  cent.,  were 
Jewish." 

Although  Dr.  Richardson  admits  it  would  be  unfair 
to  accept  the  above  figures  as  a  basis  for  general  appli- 
cation, he  argues  that  the}'  are,  on  the  average,  sufficiently 
suggestive,  as  among  the  Saxons  it  was  noticed  that 
there  were  more  cases  in  whom  the  disease  was  heredi- 
tar3%  while  among  the  others  it  was  generally  acquired. 

In  going  over  the  subject  of  this  question  in  regard 
to  phthisis,  we  must  admit  that,  although  the  Jew  in  his 
own  home,  synagogue,  or  in  his  social  reunions,  is  not 


What  are  the  Benefits  of  Cii'cunicision?        1T9 

exposed  to  tubercular  emanations,  and  that  he  has  less 
chance  of  contracting  the  disease  from  tuberculous 
meats,  he  is,  after  all,  a  theatre-goer;  a  pretty  con- 
stant inhabitant  of  the  sleeping-car  and  hotel,  as  a  com- 
mercial traveler  and  general  merchant ;  and  that,  on  the 
whole,  he  eats  the  same  food,  breathes  the  air  and  dust 
of  the  same  streets,  and  drinks  the  same  milk  and  water 
as  the  Christian,  and,  as  observed  by  Dr.  Billings,  cook- 
ing destroys  the  bacillus  in  meats.  So  that  the  compara- 
tive exposure  in  this  country — where  the  practice  is  not 
as  prevalent  as  in  Germany  of  eating  raw  minced-meat 
sandwiches — existing  between  the  Jew  and  the  Christian 
to  tubercular  infection  from  meat  are  about  equal.  The 
records  of  the  Jewish  Hospital  of  New  York  gives,  out 
of  28,750  persons  admitted,  only  44.17  per  1000  of  its 
admissions  as  being  due  to  consumption  ;  while  those  of 
the  Roosevelt  Hospital,  out  of  25,583  admissions,  gives 
a  per  1000  of  67.93. 

From  what  is  known  of  the  relation  of  syphilis  to 
consumption,  not  only  as  affecting  the  primary  indi- 
vidual, but  the  subsequent  generations  of  the  same,  and 
the  known  greater  exemption  of  the  Jew  to  sj^philitic 
infection,  owing  to  the  protecting  influence  of  circum- 
cision, it  is  safe  to  assert  that  therein  is  to  be  found  one 
of  the  main  reasons  of  the  exemption  of  that  race  to 
consumption.  If  we  but  look  at  the  geographical  dis- 
tribution of  phthisis  and  the  historj^  of  its  progress,  we 
shall  find  that  it  has  had  s^-philis  as  its  avant  courrier  on 
more  than  one  occasian.  Lancereaux,  in  his  "  Distribu- 
tion of  Pulmonary  Phthisis,"  points  to  the  fact  that 
where  consumption  has  made  its  greatest  raA'ages,  and 
where  it  has  nearly  depopulated  one  of  the  great  divi- 
sions of  the  globe, — namel3',the  groups  of  islands  in  the 
Pacific  Ocean, — the   disease   had   no   existence   at  the 


180  History  of  Cir-cumcision. 

beginning  of  the  present  centuiy.  Sj-pbilis,  scrofula, 
and  a  quick,  galloping  consumption  have,  since  the  last 
ninety  years,  taken  off  the  greater  part  of  the  popula- 
tion. The  same  course  of  transition  from  the  best  of 
physical  conditions  to  racial  deterioration  and  extinction 
from  the  same  relative  condition  of  causes — syphilis, 
scrofula,  and  phthisis — has  been  observed  among  the 
open-air  dwellers  of  the  Ncav  Mexican  Plains,  in  the 
mountains  of  Arizona,  and  on  the  arid  wastes  of  the 
Colorado  Desert,  where  the  ajjpearance  of  consumption 
cannot  be  attributed  to  housing  or  incipient  civilization, 
as  it  is  attributed  to  housing  among  the  Chippeways, 
Sioux,  or  Mandans  in  the  regions  that  formerly  formed 
the  Northwest  Territory.  The  question  is  very  plainly 
answered  as  to  how  consumption  was  introduced  or 
■whence  it  sprung  that  has  so  ravaged  the  Oceanic 
Islands.  The  sailors  who  first  visited  those  islands  were 
not,  as  a  rule,  a  batch  of  consumptive  tourists  on  a  voy- 
age in  search  of  health  or  recreation  ;  but  we  can  well 
understand  that  the  proverbially  improvident  mariner 
has  not  alwa3'S  had  his  health  looked  after  by  an  Anson 
or  a  Cook,  and  that  man}'  a  festive  tar  who  induced  the 
unsophisticated  Indian  maid  to  join  him  in  worship  at 
the  shrine  of  Venus  Poi'cina  carried  in  the  innermost 
recesses  of  the  folds  of  his  pendulous  and  sea-beaten 
prepuce  the  remnants  of  former  Bacchanalian  festivities 
performed  in  the  questionable  temples  of  Venus  and 
Bacchus  in  Portsmouth  or  London.  Consumption,  as 
such,  was  neither  imported  nor  propagated  by  Europeans 
into  those  islands,  its  original  entry  being  in  the  shape 
of  S3'^philis.  Had  it  been  the  ancient  mariners  of  old 
Phoenicia  in  the  days  of  its  circumcision,  or  the  circum- 
cised marines  of  the  ancient  Atlantean  fleets  from  the 
sunken  continent  of  Plato,  instead  of  the  uncircumcised 


What  are  the  Benefits  of  Circumcision'?         181 

sailors  of  modern  England,  that  first  and  since  visited 
tliose  islands,  it  is  safe  to  saj-  that  consumption  would 
not  now  exist  there.  From  this,  it  may  be  well  to 
inquire  what  would  be  the  relation  between  the  Jewish 
race  and  consumption  ;  were  circumcision  among  them 
to  be  done  away  with,  would  it  not  be  greatly  on  the 
increase  ? 

The  weiglit  of  testimony  is  evidently  convincing  that 
the  Jew  has  a  greater  longevit}^  and  stronger  resistance 
to  disease,  as  well  as  a  less  liability  to  physical  ills,  than 
other  races  ;  that  all  these  exemptions  or  benefits  are 
not  altogether  due  to  social  customs  is  evident;  how 
much  circumcision  ma}'^  have  to  do  in  inducing  these 
favorable  conditions  can  be  better  appreciated  by  a  con- 
sideration of  how  circumcision  affects  those  of  other 
races,  and  more  particularly  how  its  performance  works 
changes  in  the  individual  in  his  general  health  and  con- 
dition, and  in  doing  away  with  many  physical  ailments 
that  the  individual  was  previously  subjected  to.  So 
that  the  Jew  cannot  be  said  to  be  a  loser  b}^  his  observ- 
ance of  this  rite,  and  he  and  his  race  have  been  well 
repaid  for  all  the  sufferings  and  persecutions  that  its 
observance  has  subjected  them  to.  As  observed  hy  John 
Bell,  "  The  preservation  of  health  and  the  attainment  of 
long  life  are  objects  of  desire  to  every  man,  no  matter 
in  what  age  or  country  his  lot  is  cast,  nor  by  what 
arbitrary  tenure  he  holds  his  life.  They  are  the  wish  of 
tlie  master  and  the  slave,  of  the  illiterate  and  the  learned, 
of  the  timid  Hindoo  and  the  warlike  Arab,  of  the  natives 
of  New  Zealand  not  less  than  of  the  inhabitants  of  New 
England, — an  indispensable  condition  for  the  greatest 
and  longest  enjoyment  of  the  senses  and  propensities; 
for  the  widest  range  and  exercise  of  intellect  and  grati- 
fication of  the  sentiments,  whether  these   be  lofty  or 


182  History  of  Circumcision. 

ignoble,  health,  in  any  special  degree,  has  ever  been  a 
fit  subject  of  contemplation  and  instruction  by  the  phi- 
losopher and  legislator.  Their  advice  and  edicts  on  the 
means  of  preserving  it  have  frequently  been  enforced  as 
a  part  of  religious  duty,  and,  at  all  times,  civilization, 
even  in  its  elementary  forms,  has  been  marked  by  laws 
on  this  head.  With  the  numerous  and  minute  hygienic 
enactments  of  the  great  Jewish  lawgiver  for  the  guidance 
of  the  people  of  Israel  we  are  all  familiar.  Prompted, 
we  may  suppose,  in  part  by  the  example  of  Moses,  and 
also  by  considerations  growing  out  of  the  nature  of  the 
climate  in  which  he  lived,  Mohammed  incorporated  with 
the  mingled  reveries,  ethics,  and  blasphemies,  which 
composed  his  Koran,  dietetic  rules  and  observances  of 
regimen  that  are  to  this  da^^  implicitl}'  obeyed  hy  his 
zealous  followers." ^^ 

If  circumcision  is  not  a  factor  in  the  difference  that 
exists  between  the  Jewish  race  and  other  races,  if  it 
goes  for  nothing  as  an  exeraptor  of  disease  and  the  pro- 
moter of  longevity,  then  there  must  exist  some  other 
factor  or  cause  that  induces  these  conditions.  What 
this  factor  is,  the  legislator,  the  sociologist,  and  the 
pjiysician  should  make  it  their  business  to  find  out. 


CHAPTER  XY. 

Predisposition  to  and  Exemption  and  Immunity 
FROM  Disease. 

The  peculiar  differences  that  exist  between  different 
animals  in  regard  to  their  susceptibility  to  the  action 
of  drugs  is  even  more  remarkable  than  the  differences 
that  exist  in  their  susceptibility  to  certain  forms  of  dis- 
ease. We  can  understand  and  appreciate  what  Koch 
tells  us  in  regard  to  the  different  susceptibilities  ex- 
hibited by  the  house-mice  and  the  field-mice  to  the 
anthrax  bacillus,  or  why  a  nursing  child  should  offer 
different  results,  when  exposed  to  the  diphtheria  bacillus 
or  the  contagious  poison  of  any  of  the  exanthemata,  from 
those  witnessed  in  the  meat  or  promiscuously  dieted 
child.  We  can  also  appreciate  that  different  individuals 
have  different  susceptibilities  to  disease,  as  well  as  we 
understand  that  the  same  degree  is  not  always  in  an 
unvarying  point  of  resistance  or  susceptibility  in  the 
same  individual.  The  investigation  and  study  of  these 
conditions  teach  us,  however,  that  there  is  a  cause, 
or  that  there  are  causes  that  induce  and  modify  this 
susceptibility.  But  there  are  conditions  that  are  as  3'et 
beyond  onr  comprehension.  Take,  for  instance,  two 
animals,  both  vertebrates,  mammals,  and  dwelling 
together,  eating  the  same  food,  and  even  having  a  mu- 
tual understanding  or  sympathy  of  mind  and  affections, 
having  a  like  circulation,  a  like  brain  and  nervous 
system,  it  would  naturally  be  supposed  that  these  two 
would  exhibit  a  like  susceptibility  to  the  actions 
of  narcotic  poisons ;   but  when   we  are  told   that  one 

(183) 


184  History  of  Circumcision. 

dog  has  taken  21  grains  of  atropia  with  impuiiitj'- 
"we  are  staggered.  Atropia  ma}'  not  affect  rabbits  (as 
it  does  not),  but  the  rabbit  does  not  approach  man  in 
the  same  close  relationship  as  the  dog.  Richardson  ad- 
ministered to  a  health}'  young  cat  1  drachms  of  Batt- 
ley's  solution  of  opium,  then  10  grains  of  morphia,  and 
a  little  later  20  grains  more  of  morphia  without  render- 
ing the  cat  unconscious.  The  same  experimenter  gave 
to  a  pigeon  21,  30,  and  40,  then  50  grains  of  powdered 
opium  on  succeeding  daj's  with  no  bad  effect.  S.  Weir 
Mitchell  gave  to  three  pigeons,  respectively,  2Y2  drops 
of  black  drop,  21  grains  of  powdered  opium,  and  3 
grains  of  morphia  without  au}'  effect.'^^  On  the  other 
hand,  horses  show  a  like  susceptibility  to  man  to  the 
action  of  drugs.  In  the  island  of  Ceylon,  a  sloth  can 
take  10  grains  of  strj'chnia  with  safety, — chickens  pre- 
senting a  like  immunity  to  the  poisonous  effects  of  this 
alkaloid.  While  the  dog  offers  such  a  contrast  to  the 
action  of  drugs  as  compai^ed  to  man,  he  is  as  subject  to 
goitre,  and  they  have  been  seen  in  a  true  state  of 
cretinism.'^' 

An  Apache,  or  Colorado  Indian,  will  prefer  a  dessert 
of  decomposed  gophers  to  one  composed  of  the  best 
canned  peaches  or  Bartlett  pears  ;  he  will  devour  the 
mass  without  any  resulting  evil,  while  a  German — after 
many  generations  of  training  on  all  forms  of  sausages 
in  every  degree  of  age  and  ripeness,  and  on  every  form 
of  cheese,  from  the  refreshing  cottage  cheese  from 
curdled  milk  and  the  delicious  cream  cheese,  down 
through  to  all  and  every  grade  as  far  as  Limburgher,  or 
maggoty,  common  cheese — has  not,  in  ever}'^  case  over- 
come the  tendency  of  the  civilized  intestine  and  con- 
stitution to  the  action  of  sausage  poison,  something 
that  has  no  effect  on  the  ordinary  Indian,  or  on  the  un- 


Disease — Predisposition^  Exemption^  Immunity.      185 

civilized  dweller  north  of  the  arctic  circle.  Even  the 
house-dog,  that  faithful  companion  of  man,  in  many 
cases  living  on  exactly  the  same  fare  as  his  master,  is 
insensible  to  the  action  of  this  poison.  An  Indian  will 
gorge  and  gormandize,  after  a  prolonged  fast,  on  such 
quantities  and  qualities  of  food  that,  if  the  ordinary 
white  man  were  to  indulge  in  a  like  feast,  he  would  be 
in  imminent  danger  of  literal  rupture  or  explosion,  or 
liable  to  end  in  sudden  apoplectic  seizures,  or,  in  case 
of  a  too  healthy  and  active  digestion,  liable,  owing  to  a 
lack  of  a  correspondingly  active  condition  of  the  excre- 
tory organs,  to  go  off  in  ur?emic  coma.  This  sporadic 
and  fitful  feasting  has  no  perceptible  effect  on  the  Indian, 
who  either  simply  works  it  oif  in  exercise,  or  sleeps  it 
off  in  a  long  and  prolonged  period  of  sleep,  during 
which  his  lungs  work  with  the  deep  and  steady  pull  and 
jjersistence  that  a  tug-boat  exhibits  when  towing  in  a 
large  ship  against  the  tide  and  a  head  wind, — working 
in  and  out  more  air  in  one  respiration  than  the  ordinary 
white  man  will  in  a  dozen.  All  these  different  con- 
ditions are  more  or  less  plain  to  us  and  as  easy  of  ex- 
planation,— just  as  plain  as  to  how  and  why  some  birds 
eat  gravel  to  improve  their  digestion.  In  the  cases  of 
different  susceptibility  to  the  action  of  strychnia  or  of 
narcotics,  the  explanation  must  of  necessity,  for  the 
present,  be  more  or  less  speculative.  But  how  are  we 
to  account,  even  in  the  way  of  speculation,  for  the  pecu- 
liar immunit}^,  lack  of  predisposition  and  hereditar}^ 
tendencies  to  disease  exhibited  b}'  the  Hebrew,  who, 
since  the  history  of  the  world,  has  beefi  a  civilized  and 
rational  being, — even  for  decades  of  centuries  before 
the  civilization  of  Europe?  Living  under  the  same 
forms  of  government,  climate,  and  shelter,  practically 
using  the  same  varieties  of  food  and  drink,  he  exhibits 


186  History  of  Circumcision. 

an  entirely  different  vitality  and  resistance  to  disease, 
decay,  and  death, — being,  in  fact,  a  puzzle  to  the  demo- 
graphic student.  The  only  really  marked  difference 
that  exists  between  this  race  and  the  otliers  lies  in  the 
fact  that  the  Hebrew  is  circumcised,  other  differences 
not  being  sufficiently  constant  to  be  accounted  as  fac- 
tors. Cii'cumcision  is,  in  the  opinion  of  the  writer,  the 
real  cause  of  the  differences  in  longevitj'^  and  faculty  for 
the  enjo^^ment  of  life  that  the  Hebrew  enjoys  in  con- 
trast to  his  Christian  brother.  Christian  and  uncir- 
cumcised  races  may  individually,  or  in  classes,  develop 
some  peculiar  immunity  or  exemption,  as,  for  instance, 
the  tolerance  to  arsenic  exhibited  by  some  German 
mountaineers,  or  the  peculiar  safet^'^  enjoj^ed  by  the 
butcher  class  from  attacks  of  continued  fever ;  ^^  but 
these  exemptions  are  purchased  at  the  expense  of 
the  future,  the  effects  of  arsenic,  long  continued, 
finally  having  its  morbid  effects,  and  the  very  plethora 
which  is  the  bulwark  of  resistance  in  the  butcher,  this 
plethora  being  in  the  end  a  treacherous  foe,  diseases 
result  from  it  which  make  a  sudden  ending  to  this  class 
when  it  is  least  expected. 

For  an  all  around  long-liver  the  Hebrew  holds  a  pre- 
eminence, and,  as  the  factor  in  this  pre-eminence,  cir- 
cumcision has  no  counter-claimant.  Circumcision  is 
like  a  substantial  and  well-secured  life-annuity;  every 
year  of  life  3'ou  draw  the  benefit,  and  it  has  not  any 
drawbacks  or  after-claps.  Parents  cannot  make  a  better 
paying  investment  for  their  little  boj's,  as  it  insures 
them  better  health,  greater  capacity  for  labor,  longer 
life,  less  nervousness,  sickness,  loss  of  time,  and  less 
doctor-bills,  as  well  as  it  increases  their  chances  for  an 
euthanasian  death. 


CHAPTER  XVI. 

The  Prepuce,  Syphilis,  and  Phthisis. 

It  is  not  alone  the  tight-constricted,  glans-deforming, 
onan ism-producing,  cancer-generating  prepuce  that  is 
the  particular  variety  of  prepuce  that  is  at  the  bottom 
of  the  ills  and  ailments,  local  or  constitutional,  that  may 
affect  man  through  its  presence.  The  loose,  pendulous 
prepuce,  or  even  the  prepuce  in  the  evolutionary  stage  of 
disappearance,  that  only  loosely  covers  one-half  of  the 
glans,  is  as  dangerons  as  his  long  and  constricted  counter- 
part. If  we  look  over  the  "world's  history,  since  in  the 
latter  years  of  the  fifteenth  century  syphilis  came  down 
like  a  plague,  walking  with  democratic  tread  through  all 
walks  and  stations  in  life,la3-ing  out  alike  royalty  or  the 
vagrant,  the  curled-haired  and  slashed-doubleted  knight, 
or  the  tonsured  monk,  we  must  conclude  that  sj-philis 
has  caused  morei  families  to  become  extinct  than  any 
ordinary  plague,  black  death,  or  cholera  epidemic. 
Without  wishing  to  enter  into  a  histor}-  of  syphilis,  it  is 
not  outside  of  the  province  of  this  book  to  allude  to  its 
frequency  and  spread. 

Sj'philis  is  not  restricted  to  classes  by  any  means  ; 
it  is  not  those  of  the  lower  class  alone  who  are  its 
victims.  Dr.  Fr.  J.  Behrend,  in  his  work,  "  Die  Prosti- 
tution in  Berlin,"  observes  that  abolition  of  the  brothels 
in  that  city  in  184:5,  '46,  '47  and  '48,  trebled  the  number 
of  cases  of  syphilis  treated  at  the  Der  Charite;  in  the 
year  1848  the  cases  of  syphilis  treated  at  that  hospital 
numbered  over  1800.  It  was  also  remarked  during  this 
period  of  legally-enforced  virtue,  that,  as  inconsistently 

(187) 


188  History  of  Circumcision. 

as  it  might  appear,  the  disease  invaded  the  best  of  fami- 
lies. From  Dr.  Neumann,  in  his  brochure  entitled  "  Die 
Berliner  Syphilisfrage,"  published  in  1852,  we  learn 
that,  in  the  Trades  and  Mechanics'  Benevolent  Union  of 
Berlin,  in  1849,  13.51  per  cent,  of  the  sick  were  so  from 
sjrphilis. 

In  the  thirteenth  volume  of  the  British  and  Foreign 
Medico-Chirurgical  Review^  we  find,  in  a  review  of  the 
control  of  prostitution,  an  estimate  in  regard  to  the 
s3'philization  of  a  nation.  The  estimates  are  made  on 
the  most  conservative  figures,  as,  in  the  desire  of  the 
reviewer  not  to  overestimate,  he  starts  by  figuring  out 
the  actual  number  of  prostitutes  in  England,  Wales,  and 
Scotland  to  be  only  50,000,  when  they  were  estimated, 
by  those  who  had  carefully  studied  the  subject,  as  being 
more  than  double  that  number ;  the  conservative  esti- 
mate is,  however,  suitable  for  our  purpose  ;  so  that  we 
cannot  be  accused  of  overestimating  the  results.  The 
portion  of  the  review  to  which  we  wish  to  call  attention 
is  as  follows  : — 

"  Though  the  result  of  the  evidence* contained  in  the 
first  report  of  the  commissioners  on  the  constabulary 
force  of  England  and  Wales  was  that  at  that  time  about  2 
per  cent,  of  the  prostitutes  of  London  were  suffering 
under  some  form  of  venereal  disease,  3' et  we  will  descend 
even  lower,  and  presume  that  of  one  hundred  healthy 
prostitutes,  taken  promiscuousl}'^  from  England  and 
Scotland,  if  each  submits  to  one  indiscriminate  sexual 
act  in  twenty-four  hours,  not  more  than  one  would  be- 
come infected  with  syphilis,  an  estimate  which  is  without 
doubt  far  too  low;  yet,  if  admitted  to  be  correct,  the 
necessary  consequence  will  be,  that  of  the  fifty  thousand 
prostitutes  five  hundred  are  diseased  within  the  aforesaid 
twenty -four  hours. 


The  Prepuce^  Syphilis,  and  Phthisis.  189 

"  If  we  next  admit  that  a  fifth  of  these  five  hundred 
diseased  women  are  admitted  to  hospital  on  tlie  da}'  on 
which  the  disease  appears,  it  follows  that  there  are  every 
day  on  the  streets  four  hundred  diseased  women.  Let  it 
be  supposed  tliat  the  power  of  these  four  hundred  to 
infect  be  limited  to  twelve  daj's,  and  that  of  every  six 
persons  who,  at  the  rate  of  one  each  night,  have  con- 
nection with  these  women,  five  become  infected,  it  will 
follow  that  there  will  be  four  thousand  men  infected 
every  night,  and  consequently  one  million  four  hundred 
and  sixty  thousand  in  the  year.  Further,  as  there  are 
every  night  four  hundred  women  diseased  by  these  men, 
one  hundred  and  eighty-two  thousand  five  hundred 
public  prostitutes  will  be  syphilized  during  the  year; 
hence,  one  million  six  hundred  and  fifty-two  thousand 
five  hundred  cases  of  syphilis  in  both  sexes  occur  every 
twelve  months. 

"  If,  then,  the  entire  population  had  intercourse  with 
prostitutes  in  an  equal  ratio,  the  gross  population  of 
Great  Britain,  of  all  ages  and  sexes,  would,  during 
eighteen  years,  have  been  afi^ected  with  primary  syphilis. 
Be  it  remembered,  we  do  not  assert  that  more  than  a 
million  and  a  half  of  persons  are  attacked  every  year, 
but  that  that  number  of  cases  occurs  annuall}^  in  Eng- 
land, Wales,  and  Scotland,  though  the  same  individual 
may  be  attacked  more  than  once.  Although  it  is  evi- 
dent that  all  the  estimates  used  for  these  calculations 
are  (we  know  no  other  word  that  expresses  it)  ridicu- 
lously low,  yet  we  find  that  more  than  a  million  and 
a  half  of  cases  of  sj-philis  occur  every  j^ear, — an 
amount  which  is  probably  not  half  the  actual  num- 
ber. How  enormous,  then,  must  be  the  number  of  chil- 
dren bom  with  secondary  disease  I  How  immense  the 
mortality  among  them  I    How  vast  an  amount  of  public 


190  History  of  Circumcision. 

and  private  money  expended  on  the  cure  of  this  dis- 
ease 1" 

The  same  reviewer  (P.  S.  Holland),  in  another  article 
on  the  "  Control  of  Pi'ostitution,"  observes  that  among 
the  British  troops  sj'philis  is  one  of  the  most  frequent 
of  diseases,  about  one  hundred  and  eighty  cases  occur- 
ring annually  among  every  one  thousand  soldiers. 

The  effect  of  syphilis  in  depopulating  the  islands  of 
the  Pacific  has  been  pointed  out  in  a  former  chapter;  the 
nature  and  origin  of  the  disease  that  takes  them  off  is  un- 
mistakable. Scrofula  and  rapid  phthisis  are  taking  off"  the 
inhabitants  at  a  rate  that,  in  those  islands  most  aflTected, 
the  native  population  will  soon  become  extinct.  Accord- 
ing to  Lancereaux,  in  the  Marquesas  group  the  women  do 
not  live  beyond  the  age  of  thirt}'^  to  thirty-five  years, 
three  or  four  months  being  the  duration  of  the  disease. 
Ellis,  in  his  "  Polynesian  Researches,"  published  in 
1836,  remarks  that  at  that  date  the  disease,  as  above 
described,  had  but  recently  appeared.  In  the  nine- 
teenth volume  of  the  "Archives  de  Medecine  Navale," 
Rey  mentions  that  at  the  Easter  Island  pulmonary 
phthisis  is  the  dominant  affection  with  the  adults,  and 
that  scrofula  is  very  prevalent  with  the  children.^* 

The  eflTect  of  syphilization  in  inducing  a  scrofulous 
taint  and  the  appearance  of  a  rapidly-marching  con- 
sumption among  savage  races  has  been  well  observed 
among  the  Indians  in  the  southwestern  parts  of  the 
United  States,  where  the  appearance  of  these  fatal  dis- 
eases can  easily  be  traced  to  that  as  a  cause.  There  is 
something  peculiar  about  the  Anglo-Saxon  race  that  is 
fatal  to  the  Indian  ;  wherever  they  come  in  contact,  the 
savage  race  begins  physically  and  morallj^  to  crumble; 
the  habits  of  the  Anglo-Saxon  in  the  matter  of  in- 
temperance and    his   lust  soon  end  the  poor  Indian ; 


The  Prepuce,  Syphilis,  and  Phthisis.  191 

while,  on  the  other  hand,  the  Latin  races  mix  with  them 
without  any  physical  detriment  to  the  Indian.  In  what 
was  formerly  the  Northwest  Territoi-y  the  French  and 
Indian  intermarried,  and  syphilis  did  not  begin  to  tell 
on  the  Indian  until  the  Americans  settled  the  country. 
From  these  observations  it  is  very  evident  that  in  the 
Polynesian  Archipelago  syphilis  must  have  been  the 
precursor  of  tlie  phthisis  and  scrofula,  as  we  know  it 
to  have  been  that  which  induced  those  diseases  among 
the  Indians  of  the  Mississippi  or  Missouri  Valley's,  or 
of  the  Colorado  and  Mojave  Deserts,  or  in  the  mountains 
and  vallej's  of  Arizona, 

On  the  other  hand,  circumcised  races,  whose  women 
have  not  carried  a  svphilitic  taint  into  the  race,  are  as  a 
class  free  from  an}' S3'philitic  taint.  Neither  their  teeth, 
physiognomy,  skin,  nor  general  condition  denote  any 
syphilitic  inheritance.  This  is  true  of  the  Jewish  de- 
scendants of  Abraham,  who  have  more  strictl}^  adhered 
to  the  non-intercourse  or  marriage  with  other  races,  and 
whose  women  have  abstained  from  vice;  the  Arabian, 
descendants  of  Islimael  haA'e,  in  a  great  measure,  also 
retained  their  marked  famil^^  individuality,  except  it  be  a 
few  tribes,  who,  hy  contact  with  tlie  soldier^^  of  European 
nations,  have  had  their  women  corrupted  and  syphilis 
introduced  into  the  tribe  tlirough  this  channel. 

Richardson,  in  his  "  Preventive  Medicine,"  observ- 
ing on  the  effects  of  syphilis  in  inducing  deterioration 
of  the  organs  of  circulation  and  their  degenerative 
changes,  says  that,  in  his  opinion,  syphilis  is  the  pro- 
genitor of  various  diseases,  and  that  those  who  give  this 
opinion  the  greatest  range  are,  unfortunately,  nearest 
the  truth.  The  breathing  organs,  he  remarks,  are  dis- 
tinctly susceptible  to  injury  from  this  hereditarj'  cause. 

In  1854j  at  the  Metropolitan  Free  Hospital,  situated 


192  History  of  Circumcision 

in  the  Jews'  quarter  in  London,  Hutchinson  observed 
that  tlie  proportion  of  Jcavs  to  Christians  among  the 
out-patients  was  as  one  to  three ;  at  the  same  time  the 
proportion  of  cases  of  syphilis  in  the  former  to  the 
latter  was  one  to  fifteen.  Now,  this  result  was  not  due 
to  any  extra  moralitj^  on  the  part  of  the  Jews,  as  fully 
one-half  of  the  gonorrhoea  cases  occurred  among  those 
of  that  faith.  J.  Royes  Bell  also  observes  the  less 
sj-philization  among  circumcised  races.'^^ 

The  absence  of  the  prepuce  and  the  non-absorbing 
character  of  the  skin  of  the  glans  penis,  made  so  by  con- 
stant exposure,  with  the  necessary  and  unavoidably  less 
tendency  that  these  conditions  give  to  favor  syphilitic 
inoculation,  are  not  evidently  without  their  resulting 
good  effects.  Now  and  then  syphilitic  primary  sores  are 
found  on  the  glans,  or  even  in  the  urethra  or  on  the 
outside  skin  of  the  penis,  or  outer  parts  of  the  prepuce; 
but  the  majorit}^  are,  as  a  rule,  situated  either  back  of 
the  corona  or  on  the  reflected  inner  fold  of  the  prepuce 
immediately  adjoining  the  corona,  or  they  may  be  in  the 
loose  folds  in  the  neighborhood  of  the  frenum,the  reten- 
tion of  the  virus  seemingly  being  assisted  by  the  topo- 
graphical condition  and  relation  of  the  parts,  and  its 
absorption  facilitated  by  the  thinness  of  the  mucous 
membrane,  as  well  as  by  the  active  circulation  and 
moisture  and  heat  of  the  parts.  It  must  be  evident 
that  but  for  these  favoring  conditions  the  inoculation 
or  infection  would  and  could  not  be  either  as  sure  or  as 
frequent.  Any  protecting  mechanical  aid  that  interferes 
with  these  favoring  conditions  grants  an  immunity  to 
the  individual,  even  when  he  is  freely  exposed  ;  this  pro- 
tection has  often  been  obtained  by  applying  to  the  glans 
and  penis  a  substantial  coat  of  some  tenacious  oil  like 
castor-oil,  which  was  afterward  gently  washed  ofi",  first 


The  Prepuce,  Syphilis^,  and  Phthisis.  193 

in  a  shower  of  tepid  water  and  afterward  in  a  tepid  bath 
of  warm  water  and  borax. 

Horner,  formerly  of  the  navy,  in  his  interesting  little 
work  on  "  Naval  Practice," ^^  relates  that  it  was  cus- 
tomary, in  the  older  nav^-  of  the  United  States,  to  allow 
public  women  to  come  on  board  at  some  of  the  ports 
and  to  go  down  to  tbe  men  between  decks,  the  De- 
partment of  the  Navy  being  probably  actuated  by  the 
same  humane  principle  that  used  to  induce  some  of  the 
West  Indian  cannibals  to  lend  their  wives  to  their  pris- 
oners of  war  who  were  intended,  in  the  shape  of  roast 
or  fricandeau,  to  grace  the  festive  board,  as  it  was 
deemed  inhuman  by  these  philanthropists  to  deprive  a 
man  of  his  necessary  sexual  intercourse,  even  if  they 
were  soon  to  roast  him  and  pick  his  bones.  Thej'^  naaj'-, 
however,  have  been  selfish  in  the  matter,  as  by  some  au- 
thorities it  is  represented  that  this  was  done  to  improve 
the  flavor  of  the  prisoner,  who  was  said  to  offer  a  more 
savory  dish  through  this  considerate  treatment,  the 
sti'ong  flavor  that  the  semen  gives  to  flesh  being  well 
eradicated  by  free  fornication.  Whether  it  was  through 
these  motives  of  humanitarianism,  or  the  feeling  that  an 
American  tar  was  the  equal  of  the  British  tar,  whose 
praises  and  equalitj^  Sir  Joseph  Porter,  K.C.B.,  writes  a 
song  about  in  "  Pinafore,"  who  had  as  much  right  to 
conti'act  a  left-handed  marriage  as  any  Prince  of  Wales 
or  any  other  prince  or  crowned  head  of  Europe,  the 
women  were,  nevertheless,  allowed  to  go  down  between 
decks  in  preference  to  giving  the  men  indiscriminate 
liberty  on  shore,  the  government  further  providing  for 
their  welfare  by  causing  the  assistant  surgeon  to  ex- 
amine the  women  at  the  gangwaj'^  or  hatchway,  to  see 
that  they  were  not  diseased.  Horner  relates  the  ludi- 
crous appearance  presented  by  a  near-sighted  assistant 


194  History  of  Circumcision. 

fit  one  of  the  hatchways  while  mnking  this  professional 
examination,  surrounded  bj'  tlie  sailors  and  marines,  who 
were  greatlj- -interested  spectators.  Had  the  govern- 
ment provided  a  pot  of  castor-oil  wherein  the  tar  could 
dip  his  penile  organ,  as  bridge  piles  are  dipped  into  a 
creasoting  mixture,  these  humiliations  to  our  profes- 
sional brother  could  have  been  avoided. 

In  the  conclusion  to  be  reached,  circumcision  is  not 
put  forward  as  the  only  exempting  element  or  preventive 
measure  that  deserves  all  the  credit  for  the  immunity 
that  the  Jews  enjoy  from  syphilis,  or  to  the  absence  of 
hereditary  diseases  that  are  secondary'  or  due  to  the 
presence  of  that  dise:>se  in  the  pai'ents,  as  considerable 
credit  is  to  be  given  to  the  well-known  chastity  of  their 
females.  This  chastity  is,  in  a  great  measure,  due  to 
the  inseparable  conditions  of  their  religion, — moral  and 
social  fabrics  which  are  welded  into  one.  Their  charity 
assumes  the  most  practical  form,  so  that  it  is  not  pos- 
sible for  one  of  their  females  to  haA-e  to  resort  to  a  life  of 
prostitution  to  save  herself  or  her  children  from  starva- 
tion, as,  unfortunately,  is  too  often  the  case  in  Christian 
communities,  where  religion  is  put  on  and  off  with  Sun- 
day clothes.  The  temperance  and  sobrietj',  as  well  as 
the  economy  and  industry'  of  the  father,  are  not  without 
a  good  moral  as  well  as  a  hereditary  effect  on  the 
daughters,  who  are  neither  rendered  brutal  nor  demoral- 
ized through  the  example  and  instigation  of  drunken 
fathers.  They  have,  therefore,  a  better  average  home- 
life,  to  which  they  cling  and  which  protects  them.  The 
aid  and.  benevolent  associations  of  the  Jews  are  among 
the  most  efficacious  of  charitable  institutions,  and  no 
class  gives  more  freel}'  or  generously  for  this  purpose. 
The  Home  for  Aged  Hebrews  in  New  York  is  an  example 
of  the  character  with  which  they  dispense  charitj'.    We 


The  Prepuce^  Syphilis,  and  Phthisis.  195 

need  not,  therefore,  be  suprised  to  find,  in  statistics 
of  illegitimacy  by  religious  denominations  taken  in 
Prussia,  that  the  Jewish  women  are  three  times  as 
chaste  as  the  Catholics  and  more  than  four  times  as 
chaste  as  the  Evangelists.'^^  The  Jew  has,  therefore, 
two  avenues  of  infection  from  syphilis  cut  off, — the 
lesser  liability  due  to  his  circumcision  and  the  chastity 
of  the  women. 

Richardson  mentions  the  immunit}'  of  the  Jewish 
race  from  tubercular  disease,  and  notices  the  well-known 
relation  existing  between  a  syphilitic  taint  and  a 
phthisical  tendency.  The  comparative  statistics  offered 
b}'  the  Mohammedans,  Jews,  and  Christians  in  regard 
to  deaths  from  consumption  have  already  been  men- 
tioned in  a  former  chapter,  they  being  as  four  Christians 
to  one  Jew,  while  the  Mohammedan,  from  his  greater 
abstemiousness  and  temperance  to  assist  him,  shows  a 
still  lower  percentage  than  the  Jew.  There  can  be  but 
little  doubt  that  to  this  particular  and  well-marked 
less  s3'philization  the  Hebrew  race  owes  much  of  its 
exemption  from  many  other  diseases  and  its  greater 
resistance  to  ordinary  ailments  and  epidemic  diseases. 

The  relative  less  frequency  of  syphilis  among  all 
circumcised  people  is  noticed  b}'  Dr.  Bernheim,  in 
his  brochure  "  De  la  Circoncision,"  he  being  the  sur- 
geon of  the  Israelitish  Consistory  of  Paris.  His  utter- 
ances on  this  subject  are  worthy  of  attention,  he  having 
not  only  paid  particular  attention  to  this,  but  having 
had  imusual  opportunities  for  the  basis  of  his  opinions. 
Dr.  Bernheim  looks  upon  coition  as  a  frequent  source 
of  tubercular  infection,  and  the  sensitive  and  absorbing 
covering  of  the  uncircumcised  glans  as  a  ready  medium 
of  transmission  of  the  virus  from  one  sj'stem  to  the 
other.     He  calls  attention  to  the  frequent  granular  con- 


196  History  of  Circumcision. 

ditioii  of  the  uterine  os,  in  confirmed  cases  of  tubercu- 
losis, as  something  that  is  too  much  overlooked.  This 
view  of  tiie  case,  from  Dr.  Bernheim's  stand-point,  is 
worthy  of  greater  considei'ation  than  it  has  generally 
received  at  the  liands  of  the  profession. 

The  great  number  of  examples  that  have  recentlj'- 
come  to  light  in  connection  with  the  direct  inoculability 
of  tubercular  consumption,  both  in  the  later  works  on 
phthisis  and  in  the  medical  press,  are  not  without  in- 
terest or  without  a  lesson.  The  case  recorded  within 
the  past  year  of  a  healthy  chambermaid,  who  was  Imme- 
diatel}''  inoculated  with  tubercular  matter  with  rapidly- 
following  constitutional  effects  through  a  scratch  on  the 
hand,  received  from  the  sharp  edge  of  a  broken  china 
cuspidor  that  a  consumptive  was  using,  is  one  of  these 
cases  that  are  to  the  point ;  so  it  is  evident  that  the 
uncircumcised  need  not  always  wait  for  the  degenera- 
tion of  sj'philis  into  syphilitic  phthisis  or  syphilitic 
scrofula  to  become  a  consumptive,  but  it  is  within 
the  greatest  range  of  possibility  and  probability  that  he 
may  become  at  once  a  consumptive  through  an  excoria- 
tion or  abrasion  received  during  coition  with  a  tubercu- 
lar woman.  So  many  tubercular  prostitutes  ply  their 
trade,  or,  to  be  more  definite,  so  many  prostitutes  be- 
come tubercular,  and  in  its  different  stages  follow  their 
occupation  as  the  onl3'  means  of  keeping  out  of  the 
poor-house,  that  man  runs  as  much  if  not  more  risk,  in 
consorting  with  the  class,  of  contracting  tuberculosis  - 
than  that  of  contracting  syphilis. 

There  is  something  about  s^-philis  that  is  not  gen- 
erall}^  noticed  ;  we  are  all  well  acquainted  with  the  dire 
results  that  usuallj^  follow  s^-philitic  infection,  its  course 
through  ever}'  stage  of  suffering  and  miser}^  its  trans- 
mission and  effects  in  tubercular  meningitis  or  in  syphi- 


The  Prepuce,  Syphilis,  and  Phthisis.  197 

litic  affections  of  the  mesentery  through  heredity  in 
children,  and  of  the  many  horrible  cases  of  destruction 
of  tissue,  in  skin,  mucous  membrane,  cartilage,  or  bone, 
with  their  attending  mutilations  and  disfigurations  ;  but 
there  is  no  record  of  the  great  number  of  cases,  and 
very  few  physicians  of  any  extended  practice  but  who 
can  recall  some  such  cases,  where,  after  undoubted 
syphilitic  infection,  with  the  usual  course  of  primary 
sores  and  secondary  eruption,  the  patient  has  suddenly 
blossomed  out  into  a  state  of  robust  health  that 
his  system  was  an  entire  stranger  to  before  the  infec- 
tion. The  writer  has,  in  the  course  of  a  long  practice, 
seen  a  number  of  such  results  follow  both  the  infection 
attended  with  a  miliary  eruption  and  that  followed  by 
the  large  small-pox-appearing  eruption,  both  kinds  being 
preceded  by  the  primary  sore ;  and  these  results  have 
been  observed  in  cases  of  both  what  are  called  the  soft 
and  multiple  and  the  hard  or  Hunterial  initial  sore. 
Some  of  these  cases  rapidly  gained  in  flesh,  with  an 
evident  increase  in  the  redness  of  their  blood,  increasing 
in  vigor  and  strength  with  a  ver}'  perceptibly  less  tend- 
ency to  attacks  from  accidental  or  previously  subject-to 
diseases. 

The  same  result  has  been  observed  to  follow  an 
attack  of  small-pox  with  some  individuals,  and  the 
writer  well  remembers  a  similar  result  following  a  very 
extraordinary  event.  The  subject  was  a  man  well 
known  among  his  old  comrades  of  the  First  Minnesota 
Infantry  as  "Duke,"  and  to  many  of  the  older  prac- 
titioners of  Wabashaw  County,  of  that  State,  as  "  Old 
Duke."  In  early  life  he  was  sickly  and  weak!}',  never 
having  fully  recovered  from  a  malarial  fever  contracted 
in  the  Mexican  war.  Coming  to  Minnesota,  he  adopted 
vhe  life  of  a  raftsman,  with  all  the  irregularities  that 


198  History  of  Circumcision. 

accompanied  such  a  life.  On  one  occasion,  after  a  pro- 
tracted spree,  feeling  the  need  of  stimulation  and  not 
having  the  wherewith  to  procure  it,  he  secured  a  jar  in 
which  a  snake  and  several  other  reptiles  were  preserved 
in  spirits,  and  drank  the  fluid  contents.  He  was,  some 
days  afterward,  taken  A'iolentl}'^  ill  with  a  liigh  fever  and 
racking  pains,  ending  in  an  eruption  of  boils  that  cov- 
ered him  from  head  to  foot ;  he  made  a  slow  and  tedious 
recovery  ;  but  when  recovered  lie  seemed  to  have  become 
imbued  with  a  constitution  resembling  lignuvi-vitse,  for 
a  more  stubborn-twisted  constitution  never  existed  than 
that  of"  Old  Duke."  The  power  of  resistance  that  this 
man  developed  was  something  wonderful.  Dr.  C.  P. 
Adams,  of  Hastings,  Minnesota,  and  the  St.  Paul  phy- 
sicians who  were  connected  with  the  regiment  well  re- 
member, though,  wi]-y,  precise,  and  soldierly  "  Duke," 
who,  even  in  the  old  Army  of  the  Potomac,  immersed 
up  to  his  esrs  like  the  rest  of  the  arm}'  in  the  mud  and 
dirt  of  the  encampment  of  Falmouth,  above  Fredericks- 
burg, came  out  on  general  inspection  as  prim  as  if  he 
had  just  stepped  out  of  a  bandbox,  for  which  he  received 
a  medal  for  soldierly  conduct  and  bearing. 

These  apparent  digressions  are  not  made  either  to  be 
tedious  or  to  weary  the  reader,  nor  without  an  object. 
Thej'  are  made  to  show  that,  whereas  syphilis  is  looked 
upon  as  si;cli  a  deadh'  disease,  and  it  may  be  said  to 
be  the  sole  cause  of  fear  to  the  assiduous  worshiper 
at  the  shrine  of  Venus  Porcina,  there  is  another  still 
more  fatal  danger  awaiting  him,  ambushed  in  the  folds 
of  the  vaginal  mucous  membrane,  or  coming  along 
silently  out  of  the  cervical  canal, — like  the  legions  of 
Cyrus  stealing  along  the  dry  bed  of  the  Euphrates  into 
ancient  Babylon,  to  fall  unawares  on  the  feasting  Nebu- 
chadnezzar on  that  fatal  night.     So,  in  like  manner,  the 


The  Prepuce,  Syphilis,  and  Phthisis.  199 

virus  of  tuberculosis,  either  extruding  from  a  granular 
OS  or  from  its  neigliborhood,  gradually  moves  down  on 
the  unsuspecting,  uncircumcised,  and  easily  inoculable- 
surfaced  glans  penis,  to  infect  the  sj'stem  with  a  tuber- 
cular poison  that  has  no  such  exceptions  as  those  above 
noted,  as  at  times  are  the  followers  of  syphilis.  It  is  not 
alone  the  individual  himself  that  may  be  the  sufferer 
from  this  poison,  but  his  progeny  for  several  generations 
may  have  to  suffer  for  the  infection  thus  received,  just 
as  much  as  they  would  were  that  infection  to  have  been 
sj^philitic.  As  before  remarked,  this  has  heretofore  not 
sufficiently  occupied  the  consideration  of  the  profession, 
and,  as  it  cannot  certainly  be  denied  that  such  a  source 
of  tubercular  infection  is  both  possible  and  probable,  the 
subject  is  entitled  to  more  serious  and  deliberate  con- 
sideration than  tliat  which  has  heretofore  been  paid  to  it. 
Tuberculosis  certainly  has  these  two  channels  of  en- 
trance :  either  through  direct  infection  or  throus^h  an 
evolutionary  process  resulting  from  sj'philis.  The  ap- 
pearance and  vital  statistics  offered  by  the  French  War 
Office  in  regard  to  the  Algierine  provinces,  the  report 
of  the  United  States  Census,  the  opinion  of  Dr.  Bil- 
lings deduced  from  the  census  reports,  the  opinions  of 
Hutchinson,  Richardson,  Bernheim,and  many  other  ob- 
servers, as  well  as  the  personal  but  unrecorded  observa- 
tions of  many  practitioners,  all  tend  to  bear  testimony 
to  the  remarkable  difference  that  exists  between  circum- 
cised and  uncircumcised  races  m  regard  to  the  ravages 
of  consumption.  Is  circumcision  a  factor  in  this  differ- 
ence, or  is  it  not?  If  it  is,  then  circumcision  should  re- 
ceive more  attention  than  it  has;  if  it  is  not,  then  we 
should  not  be  idle  in  hunting  up  the  cause  of  difference, 
for  an  ounce  of  prevention  is  certainly"  worth  in  this  re- 
gard a  whole  pound  of  Koch's  lymph  as  a  curative  agent. 


CHAPTER  XVII. 

Some  Reasons  for  Being  Circumcised. 

The  surgical  and  medical  histoiy  of  circumcision  is 
intimately  connected  with  the  remotest  ages,  this  being, 
in  fact,  the  earliest  surgical  procedure  of  wliich  we  have 
any  record.  From  the  same  records  we  obtain  hints  as 
to  two  conditions  for  which  circumcision  probably  was 
suggested,  either  as  a  preventive  or  as  a  remedy. 

Jahn,  in  speaking  of  the  people  by  whom  the  early 
Hebrews  were  surrounded,  mentions  their  idolatrous 
practices,  and  that  their  peculiar  forms  of  Pagan  wor- 
ship were  accompanied  by  indulgence  in  fornication, 
lascivious  songs,  and  unnatural  lust.  Others  of  their 
neighbors  worshiped  the  "  hairy  he-goat^''''  with  which 
they  also  practiced  all  manner  of  abominations.  Sodomy, 
or  pederasty,  seemed  a  sort  of  religious  ceremony  with 
some  of  these  heathen  nations  ;  from  a  religion  it  neces- 
sarily became  a  social  practice  ;  this,  in  connection  with 
the  phallic  practices  and  worship,  necessitated  frequent 
exposure  of  the  male  member.  The  evil  results,  to  say 
nothing  of  the  disgusting  and  demoralizing  tendency  of 
these  practices  of  the  Pagan,  were  evidently  well  known 
to  the  Jews.  The  contrast  between  the  physique  and 
health  of  the  pastoral  habits,  out-of-door  life  and  simple 
diet  of  the  Jews,  and  the  necessary  opposite  con- 
dition of  health  and  physique  due  to  luxury  and  to 
these  practices  among  their  neighbors,  could  not  have 
escaped  their  attention.  How  much  onanism  had  to  do 
with  the  establishment  of  circumcision  may  well  be  con- 
jectured. Again,  the  other  hint  is  in  reference  to  pro- 
(200) 


Some  Reasons  for  Being  Circumcised.  201 

creation,  as  some  stress  is  laid  to  the  connection  between 
the  conception  of  Sarah  and  the  circumcision  of  Abra- 
ham. Here  we  have  suggestions  of  a  preventive  to 
onanism,  and  a  cure  to  male  impotence  when  due  to 
preputial  interference.^* 

Strange  as  it  ma}-  seem,  these  two  important  results, 
due  to  circumcision,  seem  to  have  been  lost  sight  of  for 
some  thousands  of  years,  as  even  the  able  w'orlis  of  the 
physicians  of  the  latter  part  of  the  last  century  have 
nothing  to  say  connecting  onanism  and  circumcision. 
Neither  the  works  of  Tissot  on  male  onanism  nor  the 
pioneer  work  of  Bienville  on  nymphomania  speak  of  the 
presence  of  the  prei)uce  in  the  male,  or  of  the  nymphar 
or  clitorian  prepuce  in  the  female,  as  being  causative  of, 
or  their  removal  curative  of,  either  masturbation,  sat}'- 
riasis,  or  nymphomania ;  moral,  hygienic,  and  internal 
medication  being  by  both  these  authors  considered  to 
be  all  that  our  science  could  offer  or  do  to  alleviate  or 
cure  this  unfortunate  class.  It  is  onl}^  of  late  years  that 
circumcision,  in  its  true  relations  to  onanism,  has  re- 
ceived full  consideration.  In  regard  to  its  being  a  cure 
of  impotence,  its  recognition  has  been  of  longer  dura- 
tion. 

It  is  related  by  Leonard,  in  his  "  Memoires," — who, 
in  his  capacity  of  hair-dresser  in  ordinary  to  her  Majesty, 
the  unfortunate  Marie-Antoinette,  had  ample  oppor- 
tunit}^  for  picking  up  all  the  domestic  small  talk  of  the 
royal  family  and  their  affairs, — that  Louis  XVI,  in  ad- 
dition to  all  his  troubles  and  the  indignities  which  he 
suffered,  besides  finally  being  beheaded,  was  afflicted 
with  a  congenital  phimosis  which  prevented  the  flow  of 
semen  from  properly  discharging  itself.  It  appears  that 
his  Majesty  was  no  little  annoyed  at  not  being  able  to 
procure  an  heir  to  his  throne.     His  royal  sister-in-law, 


202  History  of  Circumcision. 

the  Countess  d'Artois,  had  given  birth  to  a  prince,  the 
Dnke  of  Angoulenie,  who  was  the  heir  presumptive 
to  the  throne  in  case  of  tlie  non-issue  from  Louis; 
another  sister-in-law  liad  been  brought  to  bed  with  a 
royal  princess,  and  here  was  the  king  himself  without 
an}'^  prospective  possibility  of  any  heir.  Like  all  kings, 
he  was  more  or  less  unreasonable;  so  he  blamed  his  first 
surgeon  in  ordinary  for  all  these  short-comings, — as  if 
it  were  the  dut}"  of  these  court  surgeons,  among  their 
many  other  tribulations,  to  furnish  heirs  to  thrones. 
The  surgeon  finally  informed  his  Mtijesty  that  if  he 
wished  to  become  a  father  it  would  be  necessarj^  for 
him  to  submit  to  the  slight  operation  that  was  the  sub- 
ject of  the  church  festival  of  the  first  day  of  January, 
namel3%  the  Feast  of  tlie  Circumcision.  His  most  Chris- 
tian Majesty  entered  a  protest  to  this  acknowledgment 
that  there  was  anything  in  Judaism  worth  imitating. 
The  surgeon  insisted  that  the  operation  celebrated  on 
the  first  of  January  would  put  him  in  a  way  to  have  tlie 
much-desired  heir.  The  king  finally  waived  all  objec- 
tions from  any  religious  scruples,  but  could  not  be 
brouglit  to  look  at  the  prospective  operation  with  any 
sentiments  of  agreeable  expectation. 

The  king  finally  became  good-natured,  and  a  touch 
of  that  plebeian  jollity  wliich  at  times  made  him  quite 
agreeable  spread  over  his  features  as  he  imagined  the 
liidicrousness  of  the  spectacle  that  would  be  presented 
by  a  king  of  France  in  the  hands  of  these  handlers  of 
the  scalpel,  treating  him  like  an  African  savage.  He  took 
some  days  to  consider  the  matter.  On  the  next  day  he 
informed  M.  Louis,  his  first  surgeon  in  ordinary,  that 
he  had  decided  on  submitting  to  the  operation,  and 
the  day  and  hour  were  fixed.  The  royal  circumcision, 
however,  never   took    place,  as   it  is  most   likely  that 


Some  Reasons  for  Being  Circumcised.  203 

in  the  privacy  of  his  chamber  his  Majesty  worlied,  like 
many  a  plebeian  or  man  of  low  degree  had  done  before 
him  and  has  done  since,  to  bring  a  refractor}^  prepuce  to 
terms.  Tlie  king  was  somewhat  of  a  mechanic,  as  his 
skill  as  a  locksmith  has  passed  into  histor}- ;  so  tliat  it 
is  not  unliliely  tluit,  with  what  little  information  he 
had  on  the  subject,  he  managed  to  sufficiently  dilate, 
by  scarification  and  stretching,  the  preputial  opening, 
as  from  the  year  1778  the  queen  had  tliree  children. 

Cases  of  attempted  self-circumcision  are  not  rarities, 
as  people  have  some  inex[)licable  idea  that  a  self-inflicted 
cut  is  not  as  painful  as  one  that  is  done  by  others.  The 
writer  well  remembers  being  called  to  assist  one  of  these 
domestic  surgeons  who  had  undertaken  to  circumcise 
himself  with  his  wife's  great  scissors.  The  man  had  a 
very  long  but  thin  and  narrow  preimce  that  had  always 
been  an  annoj'ance  to  him.  The  writer  had  circumcised 
two  of  his  children  for  the  same  malformation,  and  the 
father,  seeing  the  benefit  to  these  two,  determined  to 
share  in  the  general  benefit ;  but  at  the  same  time  he  ar- 
ranged to  do  it  all  by  himself,  and  give  the  family  and 
the  surgeon  a  sample  of  his  courage  and  a  simultaneous 
surprise  p.'vrt_y.  Securing  the  scissors,  he  wended  his 
way  unperceived  into  the  recesses  of  his  wood-shed. 
The  mental  and  ph3'sical  anguish  the  poor  man  under- 
went, and  what  soliloquies  he  must  have  addressed  to 
the  rafters  of  the  wood-shed, while  making  up  his  mind 
and  screwing  up  his  phj^sical  courage  for  the  last  fell 
act  with  the  scissors,  can  hardl}^  be  described,  as,  in  all 
probabilit}',  they  were  of  the  most  rambling  and  incon- 
sistent order.  At  any  rate,  he  must  have  reached  a 
climax  in  time  and  grasped  the  fated  prepuce  with  a 
revengeful  glee,  and,  with  all  his  powers  concentrated 
in  his  good  right  hand,  he  must  have  closed  the  re- 


204  History  of  Circumcision. 

morseless  blades  of  the  scissors  on  the  unluckj''  prepuce. 
Wlien  the  surgeon  arrived  at  the  scene  of  carnage,  he 
was  directed  to  the  wood-slied,  on  tlie  outskirts  of  whicli 
hovered  the  family,  frantic  with  fear  and  apprehension  ; 
within,  in  the  darkest  corner,  with  wildl^^  dilated  ej^es, 
and  performing  a  fantastic  pas  seul,  was  a  man  with  a 
huge  pair  of  scissors  dangling  between  his  legs,  warning 
all  hands  as  they  valued  his  life  not  to  approach  or  lay 
a  hand  on  him.  He  had  shut  the  scissors  down  so  that 
it  clinched  the  thin  prepuce,  and  there  his  courage 
and  determination  had  forsaken  him  ;  he  lost  his  pres- 
ence of  mind,  and  was  not  even  able  to  take  off  the 
scissors;  he  had  simpl}^  given  one  wild,  blood-curdling 
3^ell — like  the  last  winding  notes  from  Roland's  horn  at 
Roncevalles — that  had  brought  his  familj^  to  the  wood- 
shed-door, and  they  had  then  sent  for  a  surgeon.  New 
terrors  here  awaited  the  unluck}^  victim  for  self-circum- 
cision. He  dreaded  lest  the  surgeon  should  accidentally 
have  it  enter  his  mind  to  finish  the  operation  with  the 
scissors,  and  in  that  case  he  would  be  helpless,  as  the 
surgeon  would,  undoubtedly,  have  a  sure  and  tender 
hold  of  it.  After  executing  a  number  of  pas  a  deux  on 
the  Magilton  step,  while  the  surgeon  endeavored  to  re- 
assure him  and  gain  his  confidence,  i)romising  to  remove 
the  scissors  without  inflicting  an}^  further  harm,  he  was 
finally  allowed  to  approach,  and,  while  the  patient 
assumed  a  Taglioni  attitude  on  one  foot,  the  other  leg 
being  extended  at  right  angles  with  the  body  and  his 
hands  clawing  the  air,  the  scissors  was  removed.  The 
patient,  thi-ough  the  aid  of  lead  lotions  and  a  week's  rest, 
made  a  good  recovery  with  a  whole  prepuce,  chagrined 
at  his  failure,  but  happy  to  have  escaped  immediate 
pain.^" 

There  is  not  much  doubt  but  that  the  operation  could 


Some  Reasons  for  Being  Circumcised.  205 

have  been  suggested  hy  its,  at  times,  spontaneous  per- 
forniauce,  a  case  of  which,  b^^  Cullerier,  and  some  other 
additional  cases  liave  been  mentioned  in  a  former  chap- 
ter. Cases  occur  at  times,  also,  wherein  the  person 
having  a  previously  normal  and  uninterfering  prepuce 
has,  through  either  herpetic  inflammations  or  through 
impure  connection,  spurious  gonorrhcea,  or  the  use  of 
some  venereal-disease  preventing- wash  after  connection, 
produced  some  irritation  resulting  in  the  abnormal  thick- 
ening of  the  inner  fold,  or  an  interstitial  deposit  at  the 
function  of  the  skin  and  mucous  membrane,  with  con- 
sequent constriction,  this  deposit  finally  forming  a  hard, 
inelastic  ring,  which  prevented  a  free  exposure  of  the 
glans  and  interfered  in  sexual  connection.  In  such 
cases, — like  in  stricture  of  the  meatus, — any  mechanical 
interference  short  of  cutting  with  a  knife  only  aggra- 
vates the  existing  difficulty,  and  it  is  not  uncommon  to 
have  such  cases  apply  for  assistance  after  they  have  in 
vain  tried  to  dilate  the  constricting  preputial  orifice.  In 
the  early  writings  of  the  Greeks,  it  is  mentioned  that 
among  the  Egyptians  circumcision  exempted  them  from 
a  certain  form  of  disease  that  affected  the  penis.  Philon 
mentions  particularly  the  immunity  tliat  the  operation 
conferred  against  a  species  of  affection  which  Michel 
Levy  asserts  to  have  been  a  gangrenous  disease.  So  that, 
outside  of  any  religious  significance,  there  is  no  doubt 
that,  in  individual  cases,  circumeision  has  more  than 
once  been  suggested,  although  it  cannot  be  said  that 
sucli  individual  eases  would  ever,  or  could,  lead  to  its 
becoming  a  national  or  racial,  much  less  a  sectarian,  rite. 


CHAPTER  XYIII. 

The  Prepuce  as  an  Outlaw,  and  its  Effects  on 
THE  Glans. 

RicoRD  has  well  termed  this  appendage  to  civilized 
man  "  a  useless  bit  of  flesh."  Times  were,  however, 
wlien — man  living  in  a  wild  state,  and  when  in  imitation 
of  some  of  our  near  relatives  with  tails  and  hair^y  bodies  ; 
when  he  still  found  locomotion  on  all-fours  handier  than 
on  his  two  feet;  when  in  pursuit  of  either  the  juicy 
grasshopj)er  or  other  small  game,  or  of  the  female  of  his 
own  species  to  gratify  his  Inst,  or  in  the  frantic  rush  to 
escape  the  clutches,  fangs,  or  claws  of  a  pursuing  enem}^ 
he  was  obliged  to  fl}'  and  leap  over  thorny  briars  and 
bramble-bushes  or  hornets'  nests,  or  plunge  through 
swamps  alive  with  blood-sucking  insects  and  leeches— 
Ricord's  definition  would  certainly  have  been  inappli- 
cable. In  those  da}s,  but  for  the  protecting  double  fold 
of  the  preputial  envelope  that  protected  it  from  the  thorns 
and  cutting  grasses,  the  coarse  bark  of  trees,  or  the  stings 
and  bites  of  insects,  the  glans  penis  of  primitive  man 
would  have  often  looked  like  the  head  of  the  prover- 
biall}^  duel-disfigured  German  university  student,  or  tiie 
Bacclius-worshiping  nose  of  a  jolly  British  Boniface. 
So  that  in  those  da3  s,luiless  primitive  man  was  intended 
to  have  an  organ  tliat  resembled  a  battle-scarred  Roman 
legionary,  a  prepuce  was  an  absolute  necessit}^ 

Witii  improvement  in  man's  condition  and  his  grad- 
ual evolution  into  a  higher  sphere,  the  assumption  of 
the  erect  posture,  and  the  great  stride  in  civilization 
that  orginated  the  invention  of  the  manufacture  of  the 
(206) 


Prepuce  as  an  Outlaw,  and  its  Effects  on  the  Glans.     207 

perineal  band,  which  not  only  protected  the  glans  in  its' 
thorny  passage  through  life,  but  also  acted  like  a  pro- 
tecting aegis  to  the  scrotum  and  its  contents,  the  pre- 
puce became  a  superfluity ;  not  only  a  feuperfluit}^  but, 
now  that  its  natural  office  had  been  replaced  b^^  the  peri- 
neal cloth,  it  actually  began  to  be  a  nuisance,  as  its 
former  free  contact  with  the  air  had  retained  it  in  a 
state  of  vigorous  and  disease-resistiug  health  which  was 
now  fast  departing.  As  Montesquieu  observes,  in  the 
causes  that  led  to  the  decline  and  fall  of  the  Roman 
Empire,  those  seasons  of  trials,  tribulations,  and  struggle 
for  existence  are  those  of  health  and  progress  and 
healthy  life,  and  the  periods  of  luxur^'^  and  idleness  are 
those  of  degenerac}^  and  decay.  So  with  the  prepuce, 
the  luxury  and  idleness,  voluptuousness  and  consequent 
feasting  incident  to  its  being  supplanted  in  its  original 
functions  by  the  perineal  cloth,  which  left  it  thenceforth 
unemplo,yed,  led  it  in  the  pathway  of  disease  and  death. 
This  first  innovation  in  civilization  was  to  the  prepuce 
the  beginning  of  its  deca}^  and  fall.  Like  Belshazzar  in 
his  great  banquet-hall  in  ancient  Babj'lon,  the  prepuce 
might  have  read  the  hand-writing  on  the  wall,  "  Mene, 
Mene,  Tekel,  Upharsm,''^  and  foreseen  the  gory  end  that 
awaited  it.  Like  to  other  human  affairs,  however,  even 
in  his  fallen  estate  a  kind  word  can  be  said  for  the  pre- 
puce. Puzey,  of  Liverpool,  has  found  it  of  extreme 
value,  and  even  unequaled  by  an^^  other  part  of  the 
body,  for  furnishing  skin-grafts,*^  these  grafts  showing 
a  vitalit}'  that  is  simply  phenomenal,  considering  the 
laxity  of  its  tissues  and  its  seemingly  adipose  character. 
Tliere  is  no  doubt,  however,  that  for  skin-transplanting 
there  is  nothing  superior  to  the  plants  offered  by  the 
prepuce  of  a  boy,  and  where  uny  large  surface  is  to  be 
covered   this  should  undoubtedly  be  chosen,  as   offer- 


208  History  of  Circumcision. 

ing  the  greatest  and  quickest  success  and  the  least 
chances  of  failure.  This  is  really  the  only  disadvan- 
tage that  can  be  charged  against  circumcision,  as  in  a 
strictly  circumcised  community  they  would  be  debarred 
from  this  great  advantage.  An  uncircumcised  individ- 
iial  could  be  procured,  however,  to  supply  the  deficienc^^ 
It  is  related  that  in  the  latter  part  of  1890,  a  Knight 
Templar,  in  Cincinnati,  required  a  great  supply  of  grafts 
or  skin-plants  to  cover  a  largely-denuded  surface, 
and  that  the  whole  of  his  Commandery  chivalrously  and 
generousl3^  supplied  the  needed  skin-plants  in  a  bodj''. 
A  few  healthy  prepuces  would  have  been  more  effica- 
cious. In  advising  the  use  of  the  prepuce  for  these 
purposes  it  must  not  be  overlooked  that  in  case  of  a 
white  man  it  would  not  do  to  use  skiu  of  any  other 
color  besides  his  own.  We  have  no  data  to  base  any 
assertion  as  to  the  relative  action  of  skin-grnfts  taken 
from  Mongolians  or  Indians,  but  we  liave  very  reliable 
data  in  relation  to  the  proliferating  action  of  those  of 
the  negro,^^  which  induces  a  growth  of  epidermis  of  its 
own  kind ;  so  that  preputial  gi'afts  from  the  negro, 
combining  the  extra  vitality  and  proliferation  of  the 
preputial  tissue  with  the  strong  animal  vitality  of  the 
negro,  if  applied  to  a  white  man,  might  not  produce  the 
most  desirable  cosmetic  effects,  especially  if  on  one  side 
of  the  countenance. 

But,  taken  as  a  whole,  when  considered  in  its  relation 
to  onanism,  nocturnal  enuresis,  preputial  calculus, 
syphilis,  cancer,  and  a  lot  of  nervous  and  other  ailments, 
or  induced  abnormal  physical  conditions,  we  can  really 
conclude  that  the  days  of  the  prepuce  are  past  and  gone, 
that  it  has  outlived  its  usefulness,  and  that  those  whom 
a  religious  or  civil  ordinance  or  custom  happily  makes 
them  rid  of  it  are  people  to  be  greatly  envied.      As 


Prepuce  as  an  Outlaw^  and  its  Effects  on  the  Glans.     209 

Sanclio  Paiiza,  remarked,  "  God  bless  the  man  who  in- 
vented sleep,"  so  we  may  w^ell  join  in  blessing  the  in- 
ventor of  circumcision,  as  an  event  that  has  saved  some 
parts  of  the  human  family  from  much  ill  and  suffering. 

Pliimosis  is  an  ancient  attendant  on  our  inheritance 
of  the  prepuce,  we  being,  in  fact,  born  with  it ;  this  is 
the  rule.  There  are,  however,  exceptions  to  this  rule, 
which,  singularly  enough,  are  found  to  be  hereditary'. 
The  writer  has  met  with  a  number  of  such  instances,  and 
they  have  alwaj's  been  found  to  have  been  family'  traits. 
Within  the  past  year,  after  attending  a  confinement,  his 
attention  was  called  to  the  child  by  the  nurse,  who 
thought  that  the  child  was  deformed  ;  the  nurse,  singu- 
larly enough,  never  having  seen  a  natural-looking  glans 
penis  in  all  her  life,  was  astonished  at  the  size  and 
appearance  of  the  member.  On  examination,  the  organ 
showed  a  complete  absence  of  prepuce.  On  inquiry,  the 
father  and  another  son,  born  more  than  twenty  years 
previousl}^, — this  comprising  every  male  member  of  the 
family, — were  found  to  have  been  thus  born,  with  the 
glans  full}'  exposed.  The  family  is  now  residing  in  San 
Diego,  and  is  naturally  one  of  more  than  superior  physi- 
cal health  and  intelligence.  I  saw  another  family 
similarly  affected  in  the  north  of  France,  and  of  indi- 
vidual cases,  without  knowing  the  history  of  the  rest  of 
the  family.  I  have  seen  a  large  number.  As  the  prepuce 
can  be  observed  in  everj'  stage  of  disappearance  among 
mixed  races,  it  would  seem  that  in  time  it  would  disap- 
pear altogether.  Its  effectual  absence  in  so  many  cases 
evidently''  belongs  to  some  evolutionar}'  process,  and 
shows  beyond  question  that  nature  does  not  insist  on 
its  presence  either  as  a  necessitj'  or  as  an  ornament. 

The  word  or  term  "  phimosis  "  is  derived  from  two 
Grreek  roots,  signifying  "string"  and  "to  tighten,"  or 


210  JSisto7'y  of  Circumcision. 

"to  tie  with  a  string."  Galen,  from  its  signification, 
accepted  the  word,  and  from  him  it  has  been  transmitted 
through  the  different  epochs  of  medicine  down  to  our 
own  times.  In  virtue  of  its  etj'mological  significance, 
it  was  formerly  applied  to  an}-  stenosis  or  closure  of 
duct  or  aperture,  but  at  present  the  term  is  used  simply 
to  denote  tliat  constriction  that  aflfects  the  prepuce,  and 
whicli  prevents  the  glans  from  being  passed  through  the 
preputial  orifice.  Phimosis  is  said  to  be  congenital  or 
natural  and  acquired.  The  first  of  these  is  the  common 
lot  of  all,  as  a  rule,  and  with  some  it  remains  so  through- 
out life.  As  babyhood  advances  in  bojiiood  and  boy- 
hood into  3^outh,  the  prepuce  gradual]}^  becomes  lax  and 
distensible,  and  in  proportion  to  the  existence  of  these 
conditions  it  also  loses  in  its  length.  Where,  however, 
the  distal  end  persists  in  its  constricted  condition  it  is 
drawn  forward  as  the  penis  increases  in  bulk. 

In  many  cases  its  tightness  prevents  the  escape  of 
the  sebaceous  matter  that  collects  in  the  sulcus  back  of 
tlie  corona,  and  the  resulting  irritation  on  the  surface 
of  the  glans  and  the  inner  mucous  fold  of  the  prepuce 
ends  in  an  inflammatorjr  thickening  of  the  latter,  its 
inner  surface  becoming  thick,  undilatable,  hard,  and  un- 
yielding, all  the  natural  elasticity  that  should  be  present 
having  departed,  with  more  or  less  inflammatory  thick- 
ening and  adhesions  between  the  two  layers  of  skin  that 
form  the  prepuce.  In  this  unyielding  tube  the  glans  is 
imprisoned  and  compressed,  often  suff"eriug  the  tortures 
that  the  "maiden"  of  the  dungeons  of  the  Inquisition 
inflicted  on  the  unhapp}^  heretics.  It  becomes  elongated, 
cyanosed,  and  h3'persesthetic  ;  the  meatus  of  the  urethra 
is  congested  and  liypertrophied  ;  the  corona  is  unde- 
veloped and  often  absent,  the  glans  having,  on  the 
whole,  the  long-nosed,  conical  appearance  of  the  head 


Prepuce  as  an  Outlaw,  and  its  Effects  on  the  Glans.     211 

of  a  field-mouse.  There  are  hardly  five  per  cent,  of  the 
uncircumcised  but  who  suffer  in  some  degree  from  this 
constricting  result  of  the  prepuce,  to  a  greater  or  less 
extent. 

On  the  other  hand,  the  unconstricted  glans  penis 
assumes  the  shape  and  appearance  that  is  seen  in  the 
circumcised.  The  head  is  shorter,  the  face  flat  and 
abrupt,  and  the  meatus,  instead  of  being  at  the  end  of  a 
conical  point,  is  situated  on  the  smooth,  rounded  front 
of  the  glans,  and  does  not  differ  in  color  from  the  cover- 
ing of  the  glans  itself.  From  the  superior  commissure 
of  the  meatus  to  the  sulcus  in  the  rear  of  the  corona  its 
topographical  outline  may  be  said  to  describe  two  oppo- 
site segments  of  a  circle,  as  seen  in  the  cuts  representing 
the  glans  in  its  natural  shape.  The  corona  is  prominent 
and  well  developed. 

The  opponents  of  circumcision  base  much  of  their 
opposition  to  the  fact  that  circumcision  interferes  witli 
the  natural  condition  of  the  parts.  The  question  may 
well  be  asked,  which  of  these  two  shaped  glans  is  the 
natural  product  as  nature  intended  it  should  be  ?  It  is 
a  well-known  fact  that  the  most  forlorn  and  mouse- 
headed,  long-nosed  glans  penis  will,  within  a  week  or 
two  after  its  liberation  from  its  fetters  of  preputial 
bands,  assume  its  true  shape.  We  may  naturally  inquire 
if  nature  made  the  glans  of  a  certain  shape,  which  seems 
to  be  the  proper  shape  for  copulative  purposes,  onh?^  to 
have  the  condition  most  effectually  abolished  by  a  con- 
stricting, unnatural  band  ?  How  much  the  shape  of  this 
glans,  from  meatus  to  corona,  may  have  to  do  with 
retaining  the  urethra  to  a  health}'  and  normal  calibre 
and  condition  has  not  been  inquired  into,  but,  as  far  as 
the  writer  has  observed,  a  normal  glans  seems  to  liave 
less  abnormalities  of  the  urethra,  and  in  treating  such 


212  History  of  Circumcision. 

cases  he  has  always  found  that  when  the  urethra  of  one 
of  these  iiormal-glans  subjects  was  affected  it  was  far 
easier  to  manage ;  while,  on  the  other  hand,  secondary 
and  even  a  tertiary  recurrence  to  an  operation  is  often 
the  fate  of  a  long,  narrow,  conical-pointed  penis. 

Phimosis  is  known  to  have  been  a  cause  of  male 
impotence  by  its  direct  interference  with  the  outward 
flow  of  the  seminal  fluid  ;  but,  although  we  have  cases 
where  impregnation  has  taken  place  by  the  aid  of  a 
warm  spoon  and  a  warm  syringe,  as  in  the  case  related 
in  a  former  chapter,  it  must  be  admitted  that  the  corona 
is  not  without  some  functional  office  in  the  act  of  pro- 
creation. Its  shape  indicates  a  valve  action  like  that  of 
the  valve  in  a  syringe-piston,  and  if  we  examine  the  two 
extremes  of  these  conditions  of  glans — one  devoid  of 
corona,  as  many  are,  and  the  other  with  the  corona  in 
its  most  pronounced  form,  when  in  a  state  of  erection — 
the  difference,  either  in  the  appearance  of  the  two  organs 
or  in  the  different  philosopliical  action  and  results  that 
must  necessarily  follow  the  use  of  these  two  differently 
shaped  glans,  will  at  once  be  apparent.  Unfortunately — 
or,  as  many  may  consider  it,  most  fortunate — the  female 
organs  are  not  always  so  shaped  as  to  be  in  themselves 
wholly  favorable  to  impregnation.  The  wearing  of  cor- 
sets, the  habitual  constipation  of  females,  the  relaxed  and 
unnatural  condition  of  the  uterine  ligaments  and  vagina 
in  civilized  women,  all  favor  uterine  displacement,  with 
any  or  all  forms  of  uterine  ailments.  To  this  we  may 
add  tiie  effect  of  repeated  miscarriages,  application  of 
astringent  washes,  irregular  menstruation,  etc.,  all  of 
which  conditions  often  result  in  an  elongation  of  the 
neck,  constriction  of  the  cervical  canal,  with  the  externnl 
OS  placed  on  the  depended  point  of  the  sharply  pointed 
cervix,  which  is  liable  to  point  in  any  direction.     Just 


Frejyuce  as  an  Outlaw,  and  its  Effects  on  the  Glans.     213 

imagine  one  of  these  conditioned  females  and  one  of  tlie 
mouse-lieaded,  covona-deficient,  long-pointed  glans  males 
in  the  act  of  coinilation  !  The  conical  penis  finds  its  way 
in  the  reflected  fold  of  the  vagina,  while  the  point  of  the 
uterus  ma^'  be  two  or  three  inches  in  some  other  direc- 
tion, making  impregnation  wholly  impossible;  besides, 
in  the  normal-shaped  penis,  the  corona  acting  as  a  valve, 
behind  which  the  circular  muscular  fibres  of  the  vagina 
close  themselves,  tends  to  retain  the  seminal  fluid  in 
front,  while  the  very  shape  of  the  organ  assists  in 
straightening  out  tlie  vaginal  canal  and  to  bring  the 
uterus  in  proper  position.  In  the  long,  thin,  narrow 
and  pointed  glans,  devoid  of  corona,  there  is  no  mechan- 
ical means  to  retain  the  seminal  discharge.  Some  years 
ago  some  one  introduced  the  idea  of  postural  copula- 
tion, to  be  tried  in  cases  of  sterility,  and  it  has  been 
found  that  impregnation  would  take  place  in  some  cases 
where  it  had  formerly  appeared  impossible,  this  position 
having  the  effect  of  righting  malpositions  during  the  act, 
which  were  the  cause  of  the  sterility;  but  it  stands  to 
reason  that,  where  the  shape  of  the  organ  is  such  that  it 
furtlier  favors  malpositions,  as  well  as  where  it  offers  no 
obstacle  to  the  vagina  immediately  expressing  or  drop- 
ping out  all  the  seminal  fluid,  impregnation  is  more 
difficult,  and  that,  where  the  uterine  deformity  is  coinci- 
dent with  this  condition  of  penis  to  assist,  it  becomes 
well  nigh  impossible.  Fodere  mentions  a  penis  about 
the  size  of  a  porcupine-quill  on  an  adult  male,  and 
Hammond  mentions  one  of  the  size  of  a  lead-pencil  in 
diameter  and  two  inches  in  length.  From  total  absence 
of  the  penis,  either  through  disease  or  accident,  to  the 
diminutive  organs  mentioned  by  Fodere  and  Hammond, 
and  on  up  to  tlie  full-sized  and  normal-shaped  organ, 
we  have  ever}'  degree  of  sizes  and  shapes,  and  with  these 


214  History  of  Circuvicision. 

go  every  conceivable  degree  of  ability  or  faculty  for 
impregnation. 

Aside  from  the  foregoing  considerations,  there  are 
others  equally  important.  Although  Greece  was  involved 
for  3'ears  in  war  and  ancient  Troy  was  destroyed  and  all 
its  inhabitants  slaughtered  because  of  the  seduction  of  one 
woman  ;  and  Semiramis,  through  her  beautj',  got  all  her 
successive  husbands  in  chancery  ;  and  poor,  susceptible 
Samson,  from  firing  Philistine  vineyards  and  killing  lions 
bare-handed,  and  the  Philistines  by  the  thousands  with 
the  jaw-bone  of  an  ass,  was  reduced  through  Delilah  to 
bitter  repentance  and  turning  Philistine  mill-stones; 
and  we  know  that  the  familiar  infatuation  of  Antony  for 
Cleopatra  ruined  Antonj^ ;  and  we  are  familiar  with  the 
well-known  maxim  of  the  French  police-minister,  that  to 
catch  a  criminal  it  was  but  necessary  to  first  locate  the 
woman  and  the  man  would  soon  be  found, — society  has 
determined  to  ignore  the  influence  of  the  animal  passions 
as  factors  in  our  every-day  life,  or  factors  in  the  estrange- 
ments, coldness,  and  the  bickerings  that  end  in  divorces. 
Not  to  shock  the  reader  with  detailed  accounts  as  to 
what  an  important  factor  the  shape  of  the  penis  may  be 
in  the  domestic  economy,  I  will  refer  the  reader  to 
Bran  tome's  works. 

Although  the  councils  of  the  older  church  were  not 
above  giving  these  conditions  their  calm  and  deliberate 
consideration,  which  resulted  in  the  foundation  of  the 
present  physical  considerations  in  relation  to  divorce 
laws,  such  studies  or  considerations  are  at  present  only 
touched  upon  gingerly  and  with  apologies  for  doing  so, 
as  if  the  "  study  of  man  "  was  of  any  less  importance 
to-day  from  what  it  was  in  the  days  of  Moses,  the  elder 
church,  or  when  Pope  formulated  his  oft-quoted  but 
little-followed  maxim,  that "  the  proper  study  of  mankind 


Prepuce  as  an  Outlaw,  and  its  Effects  on  the  Glans.     215 

is  man."  The  present  miscalled  "  delicacy  of  sentiment  " 
is  about  as  misplaced  a  condition  of  disastrous  and  mis- 
leading morality  as  was  the  out-of-place  and  untimely 
bravery  of  poor  old  Braddock  when  refusing  Washing- 
ton's advice  at  the  Monongahela.  Tiie  success  and 
beauty  of  the  Mosaic  law  is  its  squarely  facing  the  con- 
ditions of  actual  life,  and  its  absence  from  nonsense  or 
nauseating  sentimentality.  Were  our  present  churches 
to  observe  more  of  this  plain  talk,  for  which  the  good 
old  Anglo-Saxon  is  as  fully  expressive  and  convincing 
as  the  old  Hebrew,  and  deal  less  in  rhetorical  flourishes 
and  figurative  mean-nothings  to  tickle  the  ears  of  our 
modern  Pharisees,  mankind  as  well  as  womankind  would 
be  infinitely  so  much  the  better  off,  mentally,  morally, 
and  physically,  and  there  would  be  less  of  the  conflict 
between  science  and  religion.  Luther's  dream  of  restor- 
ing religion  to  its  primitive  purity  has  come  to  but  as 
poor  realization  at  the  hands  of  his  so-called  followers, 
which  leads  one  to  think  that  if  the  martyrs  of  the 
Reformation  could  come  back  and  see  the  fruits  of  their 
martyrdom — suff"ered  that  pure  religion  might  live — 
they  would  conclude  that,  for  all  the  resulting  good 
accomplished,  they  might  as  well  have  kept  a  whole 
skin  and  a  whole  set  of  bones. 

In  cases  of  pronounced  phimosis  the  aperture  in 
the  prepuce  may  not  be  in  a  line  with  the  meatus,  and 
the  resulting  discharge  of  urine  or  the  ejaculations  of 
seminal  fluid  may  from  this  cause  be  unable  to  find  an 
egress.  The  fluid  escaping  from  the  urethra  will,  in 
case  the  opening  is  at  the  side  or  upper  part  of  the  pre- 
puce, cause  it  to  balloon  out  until  a  suflficient  quantity 
is  thrown  out  so  as  to  distend  the  opening  as  well  as  the 
prepuce,  before  it  can  find  its  way  out ;  in  such  cases 
impotency  is  liable  to  be  as  complete  as  in  those  cases 


216  History  of  Circicincision. 

of  stricture  wherein  tlie  seminal  fluid  is  forced  backward 
into  the  bladder.  Having  given  this  general  view  of 
the  effects  of  phimosis  as  it  may  affect  man  in  the  shape 
of  his  organ,  wliich  ma3'  have  a  serious  result  in  his 
domestic  relations  or  in  becoming  a  fatlier,  we  will  pro- 
ceed to  the  consideration  of  diseases  and  conditions 
that  phimosis  encoui'ages  and  to  which  it  renders  man 
more  liable.  In  the  consideration  of  these  cases  it  must 
not  be  forgotten  that  the  sexual  relations  are  much 
more  to  man  or  woman  than  is  generally  acknowledged. 
The  da3s  for  the  establishment  of  the  Utopian  republic 
of  Plato  are  not  yet  with  us.  That  Platonic  love  does 
exist  is  true,  as  it  has  in  the  past  and  will  in  the  future. 
Scipio,  refusing  to  accept  the  beautiful  betrothed  bride 
of  an  enem\^  as  a  present,  or  Joseph  leaving  his  coat-tail 
in  the  hands  of  the  amorous  bride  of  the  eunuch  Poti- 
phar,  with  the  suicide  of  Lucretia,  in  the  past,  are 
events  which  virtue  and  modeini  continence  probably 
duplicate  every  day  ;  but  these  are  exceptions  to  the 
rule.  Physicians  daily  see  evidences  of  the  most 
dovoted  Platonic  affection  in  either  sex,  but  they  also 
see  enough  of  the  opposite  side  of  the  question  to  con- 
vince them  that  in  the  majorit}^  of  cases  the  sexual 
relations  are  the  bond  of  union,  as  well  as  the  main- 
spring of  love.  As  observed  by  Montesquieu,  the  bride 
of  a  first-class  Turkish  eunuch  has  but  a  sorry  time,  and 
a  woman  of  the  same  calibre  of  mind  as  that  possessed 
by  the  ordinary  Circassian  or  Armenian  bride  cannot  be 
in  a  much  happier  condition  with  a  husband  partlj'^ 
eunuchised  b}^  a  constricted  prepuce. 


CHAPTER  XIX. 

Is  THE  Prepuce  a  Natural  Physiological  AppEriDAGE  ? 

By  many  surgeons  the  idea  of  circumcision,  unless 
connected  with  an  immediate  demand  for  interference, — 
sucli  as  a  phimosis  unmanageable  by  any  other  means, 
an  induced  phimosis  from  gonorrhoea  or  other  irrita- 
tion, S3'philis  in  its  initiator}-  sore,  cancer  or  some  such 
cause, — is  looked  upon  as  an  unwarrantable  operation, a 
procedure  not  onl}-  barbarous,  painful,  and  dangerous, 
but  one  that  directly  interferes  with  the  intentions  of 
nature.  The  prepuce  is  by  many  looked  upon  as  a 
ph3'siological  necessit}'  to  health  and  the  enjoj'^ment  of 
life,  whicli,  if  removed,  is  liable  to  induce  masturbation, 
excessive  venereal  desire,  and  a  train  of  other  evils. 
The  question  then  resolves  itself.  What  is  the  real 
physiological  status  of  this  appendage,  if  it  has  any,  and, 
if  it  is  a  ph3'siological  appendage,  when  does  it  merge 
into  a  pathological  appendage?  As  by  some  it  is  held 
that  the  prepuce  enjoys  the  same  right  to  live  and  exist 
as  the  nose,  ear,  or  a  limb,  which  are  only  subject  to 
amputation  in  case  of  a  serious  disease,  they  should  be 
reminded  that  they  are  not  taking  into  consideration 
that  the  nose  and  ear  are  calculated  to  warn  us  of 
danger,  and  that  our  legs  are  very  useful ;  as  even  the 
great  orator  Demosthenes,  by  the  timely  and  rapid  use 
of  his  legs,  was  enabled  to  escape  from  a  battle,  where 
his  oratory  w^as  of  no  avail  against  the  illiterate  javelins 
of  the  unscholarly  Macedonians.  If  the  prepuce  only 
was  endowed  with  an  olfactory  sense, — as,  for  instance, 
if  a  nervous  filament  from  the  first  pair  of  nerves  had 

mi) 


218  History  of  Circumcision. 

been  sent  down  alongside  of  the  pnenmogastric  and 
then,  by  following  the  track  of  the  niammaiy  and  epi- 
gastric arteries,  had  at  last  reached  the  prepuce,  where 
the  olfactory  sense  could  have  been  turned  on  at  will, 
like  an  incandescent  lamp, — it  might  have  been  a  very 
useful  organ,  as  in  that  sense  it  could  have  scented 
danger  from  afar,  if  not  from  near,  and  enabled  man  to 
avoid  any  of  the  many  dangers  into  which  he  uncon- 
sciously drops.  But,  seeing  that  the  prepuce,  to  say 
nothing  of  being  neither  nose,  eye,  nor  ear  to  warn  one 
away  from  danger,  or  a  leg  to  run  awa}'  on  after  once  in 
it,  having  not  even  the  precautionary  sensitiveness  of  a 
cat's  jnoustachios,  it  cannot,  in  any  way  that  we  can 
see,  be  compared  to  anj-  other  useful  part  of  the  body. 

All  attempts  to  find  reasons  for  its  existence  that 
are  of  real  benefit  to  man  have  so  far  proved  unsatisfac- 
tor}',  and,  unlike  the  reasons  for  its  removal,  are,  as  a 
rule,  founded  on  speculation.  To  further  reason  out  the 
why  and  wherefore  of  its  existence  or  of  its  summary 
surgical  execution,  we  must  consider  its  shifting  posi- 
tions as  to  the  effects  it  produces,  as  well  as  to  its  con- 
ditions at  different  ages,  sitting  on  its  case  like  an 
impartial  jury  in  the  case  of  some  unconvicted  but 
diabolicalh^ -inclined  criminal. 

As  before  remarked,  we  are,  as  a  rule,  born  with  this 
appendage,  just  as  much  as  we  are  with  the  appendix 
vermiformis,  which  rises  up,  like  Banquo's  ghost,  when- 
ever we  eat  tomatoes  or  any  small-seeded  fruit.  This 
prepuce  is  then  long,  and  the  penis  is  found  at  the  end 
of  an  undilatable  canal,  which  is  formed  by  the  con- 
stricted prepuce ;  at  this  early  stage  of  our  existence  it 
is  often  additionally^  bound  down  to  the  glans  by  a 
greater  or  less  number  of  adhesions.  We  are  then  in 
what  man}'  term  a  state  of  physiological  phimosis,  that 


7s  the  Prepuce  a  Natural  Physiological  Appendage  ?    219 

being  a  perfectly  natural  condition,  and  one  consistent 
with  health  ;  at  least,  we  imagine  it  is  normal. 

Phimosis  in  childhood  is  generally  considered  a 
ph^'siological  state,  onl}'  to  be  taken  as  a  pathological 
condition  under  certain  circumstances.  Preputial  ad- 
hesions may,  according  to  man}'  observers,  also  be  classed 
as  physiological  at  an  earl}^  period  of  life,  as  it  is  by 
them  considered  as  congenital,  and  common  enough  to 
warrant  its  being  classed  as  normal.  As  to  tlie  first,  or 
phimosis,  it  undoubted I3'  is  a  phj-siological  condition 
during  infanc}' ;  but  why,  we  do  not  know  ;  and  it  is  also 
a  fact  that  from  birth  to  puberty  it  remains  so  in  fully 
over  one-half  of  the  cases.  Out  of  98  children,  from  one 
week  to  sixteen  j^ears  of  age,  examined  by  Dr.  Packard, 
the  prepuce  was  entirely  unretractable  in  64,  partly  so 
in  3,  and  wholly  so  in  36  ;  while  in  1  it  onl}'  half-covered 
the  glans  and  in  4  the  glans  was  wholly  uncovered, 
1  of  these  4  being  an  infant  only  five  weeks  old. 

Dr.  Packard  also  gives  the  result  of  172  examina- 
tions by  himself,  of  from  twelve  to  seventj' -three  years 
of  age,  and  106  examinations  by  Dr.  Maury,  a  total  of 
278,  in  whom  100  had  a  long  prepuce,  97  a  partly-covered 
glans,  and  81  (of  whom  2  had  been  circumcised)  in  whom 
the  glans  was  exposed. ^^  As  to  adhesions,  there  is  an 
unaccountable  diversity  of  opinion  as  to  their  constancy 
as  a  natural  condition,  being  frequent  enough  to  class 
them  as  phj'siological  occurrences.  Dr.  A.  B.  Arnold,  of 
Baltimore,  states  that  his  experience  in  reference  to  pre- 
putial adhesions  leads  him  to  conclude  that  the  fre- 
quency of  its  occurrence  has  been  much  overstated.  In 
the  number  of  children  that  he  has  circumcised,  which 
exceeds  1000,  he  has  met  with  it  in  less  than  four  per 
cent,  of  the  cases.  He  also  mentions  that  in  the  adult 
the  adhesions  show  greater  firmness.^* 


220  History  of  Circumcision. 

On  the  other  hand,  Dr.  Bernheira,of  the  Paris  Israel- 
itish  Consistory,  observes  that,  of  over  3000  newborn 
whom  he  has  examined,  with  but  few  exceptions  he 
found  tlie  presence  of  preputial  adhesions.  He  remarks, 
however,  that  in  the  majorit}^  these  are  detached  or 
broken  by  the  first  attempt  at  erection.^^ 

Bokai,  out  of  100  children,  found  8  who  were  over 
seven  years  of  age,  who  were  perfectly  free ;  Avhile  of 
the  remaining  92  under  that  age  6  more  showed  no  ad- 
hesions and  86  had  various  degrees  of  adhesions. ^^ 

Dr.  Holgate,  of  the  out-door  department  of  Bellevue, 
considered  that  all  phimosic  cases  have  adhesions  ;  while 
Dr.  Moses,  of  New  York,  out  of  some  fifty  circumcisions 
performed  at  the  eiglith  day,  found  only  adhesions  three 
times.^'' 

These  observations  are,  however,  in  perfect  accord. 
If  we  connect  the  statement  of  Dr.  Arnold,  in  regard  to 
the  increasing  character  of  the  firmness  in  the  adhesions 
of  the  adult,  with  the  statement  of  Dr.  Bernheim,  that 
the  first  erection  is  often  sufficient  to  break  up  the  ex- 
isting adhesions  in  the  infant,  we  must  conclude  that  they 
are  notliing  more  at  first  than  a  slight  agglutination, 
which  the  slight  manipulation  requii'ed  to  properly 
locate  the  position  of  the  glans,  and  to  space  out  the 
prepuce  preparatory  to  the  operation  of  circumcision,  < 
must,  in  the  majority  of  cases,  be  sufllcient  to  liberate 
the  prepuce  from  the  glans  ;  this  is  evident  also  from 
the  statement  of  Dr.  Moses,  who  only  found  six  per 
cent,  of  the  cases  operated  upon  b}^  him  as  being  so 
affected. 

The  writer  has  been  present  at  a  large  number  of 
Hebrew  circumcisions  performed  on  the  eighth  daj^and 
from  that  up  to  the  sixth  month  (as  in  many  communi- 
ties they  wait  until  a  number  of  children  are  collected, 


Is  the  Prepuce  a  Natural  Physiological  Appendage  f     221 

so  to  speak,  before  sending  for  the  mobel,  who  ma}^  reside 
at  quite  a  distance),  and  in  all  of  those  witnessed  he 
has  never  seen  an}^  complications  from  adhesions  ;  but 
cases  of  adhesion  have  been  often  encountered  from  the 
second  to  the  eighth  3'ear,  and  it  has  always  been  the 
case,  as  a  rule,  that  the  older  the  child  the  greater  the 
firmness  of  the  adhesion.  In  these  cases  the  practice 
generally  advised  of  using  a  probe  is  not  practicable,  as 
the  person  is  more  apt  to  wound  the  sound  prepuce 
than  to  tear  the  adhesions  ;  the  practice  most  effectual 
is  to  hold  the  glans  firmlj'  but  gently  with  the  thumb 
and  forefinger  of  the  right  hand,  and  then  to  draw  the 
prepuce  as  firmly  back  with  its  fold  held  in  the  fore- 
finger and  thumb  of  the  other.  It  is  a  more  expeditious 
mode,  and  the  least  painful;  by  this  method  extensive 
adhesions  can  readily  be  broken  up  ;  vaselin  and  a  piece 
of  fine  lint  should  then  be  interposed  for  a  couple  of 
da^'S  to  prevent  a  re-adherence. 

Another  co-existing  condition  with  phimosis,  very 
often  found,  is  a  shortening  of  the  frenum.  Dr.  Jansen, 
out  of  3700  soldiers  of  the  Belgian  army,  found  12.3 
per  cent,  with  this  pathological  condition  and  2.5  per 
cent,  with  a  narrow  prepuce. ^^ 

Take  the  three  conditions  above  enumerated, — phi- 
mosis, preputial  adhesions,  and  short  frenum, — all  are  but 
a  departure  from  a  normal,  in  a  greater  or  less  degree ; 
and  whether  the  resulting  discomfort  consists  in  mere 
mechanical  impediment  to  urination,  erection,  or  as  a 
factor  in  nocturnal  enuresis,  dysuria,  impotence,  either 
through  reflex  action  or  interference  with  emission,  mal- 
position of  the  urethral  orifice  during  copulation  owing 
to  any  of  these  conditions,  or  in  anj'^  of  the  nervous  de- 
rangements that  may  accompany  this  condition,  or  in 
the  more  serious  results,  ending  in  positive  deformity 


222  History  of  Circumcision. 

of  bod}^  oi-  limb,  or  in  the  warping  of  moral  sentiments, 
or,  even  further,  in  inducing  insanity,  it  cannot  well  be 
seen  how  the  conditions  that  will  certainly  produce 
these  results,  in  a  more  or  less  degree,  can  ever,  in  any 
logical  sense,  be  considered  a  physiological  condition. 

There  are  certain  conditions  to  life,  up  to  the  time 
of  birth,  which,  unless  the}^  then  cease  at  once  to  exist, 
immediatel}'  become  from  a  physiological  into  very 
serious  pathological  conditions.  These  are  well  under- 
stood, and  have  their  reasons  for  existing  during  our 
pre-natal  existence  ;  but  the  prepuce  has  no  known  func- 
tion during  uterine  life  or  subsequent!}'' ;  and  there  being 
no  valid  reason  for  its  existence,  there  are  certainly  no 
logical  grounds  for  its  being  considered  a  phj'siological 
condition,  especially  when  the  serious  results  attending 
the  most  accentuated  form  of  the  above  three  conditions 
are  considered,  and  as  its  necessity,  in  cases  of  its 
entire  absence,  has  not  yet  been  demonstrated. 

It  can  well  be  said  that  about  two-thirds  of  mankind 
are  affected  in  a  greater  or  less  degree  with  these  patho- 
logical conditions,  causing  them  more  or  less  annoy- 
ance. Of  these,  a  certain  percentage  suffer  a  life  of 
continued  miser^^,  as  a  direct  or  indirect  result  of  these 
conditions. 

As  to  the  actual  necessity  of  a  prepuce  existing,  or. 
as  to  what  annoyances  or  diseases  persons  are  subjected 
to  who  are  born  without  it,  there  is  a  most  singular  and 
expressive  silence  in  medical  literature.  It  stands  to 
reason  that,  if  it  is  a  necessit^'^,  some  one  person  should 
have  found  it  out  long  ago,  and  there  should  then  be 
some  evidence  to  present  in  relation  thereto.  There  are 
cases  reported  in  some  of  the  older  surgeries  wherein 
an  attempt  has  been  made,  in  the  absence  of  a  prepuce, 
to  restore  or  manufacture  one  by  means  of  a  plastic 


Is  the  Prepuce  a  Natural  Physiological  Appendage  ?     223 

operation.  Yidal  describes  sucli  an  operation  ,^^  but  there 
is  no  reason  given  as  to  why  tlie  operation  was  under- 
taken ;  there  is  no  record  of  any  diseased  condition 
which  it  was  intended  either  to  cure  or  to  alleviate  ;  so 
that  we  are  left  to  infer  that  the  person  simply  submitted 
to  the  operation  from  purely  cosmetic  reasons.  The 
Hebrews  of  Palestine,  after  the  Roman  conquest,  or 
those  in  Italy  or  Spain,  attempted  a  like  operation,  but 
not  from  any  reason  of  lessened  health  or  to  restore  any 
lacking  physiological  action,  their  aim  having  sirapl}' 
been  to  hide  their  identit}^,  for  the  purpose  of  escaping 
persecutions,  exactions,  or  annoyances,  either  from  their 
rulers  or  their  fellow-citizens. 

Dr.  A.  B.  Arnold,  in  a  paper  on  circnmcision,  read 
before  the  Academy  of  Medicine  of  Baltimore,  argues 
that  it  is  not  difficult  to  divine  the  purposes  of  the  pre- 
puce, holding  that  it  is  necessary  to  protect  the  tactile 
sensibility  of  the  glans,  due  to  the  presence  of  the 
Pacinian  bodies  which  Schweigger  Seidel  discovered  in 
the  nerves,  and  that  a  better  provision  than  the  anatomy 
of  the  prepuce  cannot  be  conceived  for  shielding  the 
very  vascular  and  sensitive  strncture  of  the  glans  from 
external  sources  of  irritation  and  friction,  that  might 
rouse  the  sensibility  of  this  organ,  which,  on  physio- 
logical grounds,  may  cause  early  masturbation  ;  further 
arguing  that,  the  corona  being  undoubtedlj^  the  most 
excitable  part  of  the  glans,  its  denudation  b}^  circum- 
cision leaves  it  more  apt  to  be  affected  by  chance  titil- 
lations.^"  In  this  latter  view  of  the  case  the  prepon- 
derance of  views  is,  however,  in  the  opposite  direction, 
J.  Roj'es  Bell  states  that,  owing  to  the  induration  of  the 
glans  through  the  means  of  circumcision,  masturbation 
and  syphilis  are  less  rife  amongst  the  circumcised  than 
amongst   the   uncircumcised.^^      M.    Lallemand,   whose 

8 


224  History  of  Circumcision. 

experience  in  tlie  treatment  of  seminal  emissions  is  of  the 
greatest  value,  looked  upon  circumcision  as  one  of  the 
means  of  curing  those  diseases,  looking  on  the  dimin- 
ished irritability  of  the  glans  resulting  from  the  opera- 
tion as  the  curative  element.^^  Dr.  Cahen,  in  a  "  Dis- 
sertation sur  la  Circoncision,"  in  1816,  before  the 
Faculty  of  Medicine  of  Paris,  called  the  attention  to 
the  diminished  sensibility  of  the  glans  induced  by 
circumcision.  Dr.  Vanier,  of  Havre,  looks  upon  the 
prepuce  as  the  most  frequent  cause  of  onanism.  "  If 
the  prepuce  is  lax,  its  mobility  produces  an  irritation  to 
the  highly  irritable  and  sensitive  nervous  system  of  the 
child  by  the  titillation  in  its  movements  on  the  glans ; 
if  too  tight  and  constricted,  then  it  compresses  the 
glans,  and  by  its  irritation  it  leads  the  child  to  seize  the 
organ."  ^^  So  that  in  either  case  he  looks  upon  the  pre- 
puce, through  the  sensitiveness  it  retains  and  induces 
in  the  glans,  as  the  principle  cause  of  masturbation.  M. 
Debreyne,  the  Trappist  monk  and  ph3^sician  of  La 
Trappe,who  has  paid  considerable  attention  to  medicine 
as  applied  to  morality,  practicall}'^  makes  the  same 
observations.  In  children  who  have  not  yet  the  sug- 
gestions of  sexual  desire  imparted  by  the  presence  of 
the  spermatic  fluid,  the  presence  of  the  prepuce  seems 
to  anticipate  those  promptings.  Circumcised  boj's  may, 
in  individual  cases,  either  through  precept  or  example, 
physical  or  mental  imperfection,  be  found  to  practice 
onanism,  but' in  genei'al  the  practice  can  be  asserted  as 
being  very  rare  among  the  children  of  circumcised 
races,  showing  the  less  irritability  of  the  organs  in  the 
class  ;  neither  in  infancy  are  they  as  liable  to  priapism 
during  sleep  as  those  that  are  uncircumcised. 

Dr.  Bernheim  says  that  "  the  prepuce  may  be  said  in 
general  to  be  an  appendage  to  man,  if  not  positively 


7s  the  Prepuce  a  Natural  Physiological  Appendage  ?     225 

harmful  in  some  cases,  at  least  useless,  requiring  con- 
stant care,  the  neglect  of  which  is  liable  to  entail  disease 
and  suffering;  the  irritation  it  produces  tlirough  the 
sebaceous  secretion  is  a  frequent  cause  of  masturbation 
which  nothing  short  of  circumcision  will  remedy." 

I'hrough  middle  life,  unless  the  prepuce  be  the  sub- 
ject of  some  vicious  conformation,  little  inconvenience 
may  result  from  its  presence,  except  it  be  from  the 
dangers  to  infections  already  pointed  out  during  this 
period  of  life;  an  ordinarily  movable  and  retractable 
prepuce  will  not  acquire  the  condition  of  phimosis, 
unless  it  be  through  disease  or  accident ;  but  with  our 
entrance  into  old  age,  or  after  having  passed  our  vigorous 
prime,  the  torment  of  the  days  of  our  infancy  and 
childhood  come  to  harass  us  again.  Persons  given  to 
corpulency,  with  a  long  prepuce,  are  apt  to  become 
affected  with  phimosis  in  their  latter  years,  as  such 
persons  are  more  subject  to  loss  of  their  sexual  vigor 
and  power  of  erection  than  lean  and  spare  people ;  in 
these,  the  gradual  diminution  of  the  size  of  the  erectile 
tissues  of  the  organ  and  its  retraction  allows  of  the 
reconstriction  of  the  preputial  opening,  which,  in  the 
end,  will  not  allow  the  prepuce  to  be  drawn  back  OA'er 
the  gland.  These  conditions  are  followed  by  the  irri- 
tating affections  incident  to  phimosis  of  our  earlier  life, 
with  the  modification  that  age  has  induced  in  making 
us  subject  to  more  serious  and  fatal  ailments,  both 
locally  and  generally. 


CHAPTER  XX. 

The  Prepuce,  Phimosis,  and  Cancer. 

In  the  British  Medical  Journal  of  Januarj^  1,  1882, 
there  is  an  interesting  article  by  Jonathan  Hutchinson 
on  the  "  Pre-cancevous  Stage  of  Cancer."  In  this  arti- 
cle he  states  that,  whereas,  twenty  years  previously,  his 
suggestion  had  been  to  treat  all  suspicious  soi-es  as 
being  clue  to  syphilis  until  a  clearer  diagnosis  could 
be  made  out,  he  "  had  more  recently  often  explained 
and  enforced  the  doctrine  of  a  pre-cancerous  stage  of 
cancer.  According  to  this  doctrine,  in  most  cases  of 
cancer,  either  of  penis,  lips,  tongue,  or  skin,  tliere  is  a 
stage — often  a  long  one — during  which  a  condition  of 
chronic  inflammation  only  is  present,  and  upon  this  the 
cancerous  process  becomes  ingrafted.  Phimosis  and 
the  consequent  balanitis  lead  to  cancer  of  the  penis. 
.  .  .  A  general  acceptance  of  the  belief  that  cancer 
usually  has  a  pre-cancerous  stage,  and  that  this  stage  is 
the  one  in  wliich  operations  ought  to  be  performed, 
would  save  many  hundreds  of  lives  every  year.  .  .  . 
Instead  of  looking  on  whilst  the  fire  smoulderd,  and 
waiting  till  it  blazed  up,  we  should  stamp  it  out  on  the 
first  suspicion.  .  .  .  What  is  a  man  the  worse  if 
vou  have  cut  away  a  warty  sore  from  his  lip  ;  and,  when 
all  is  done,  a  zealous  pathologist  demonstrates  to  you 
that  the  ulcer  is  not  cancerous,  need  j^our  conscience 
be  troubled?  You  have  operated  in  a  pre-cancerous 
stage,  and  you  have  probabl}'  effected  a  permanent  cure 
of  what  would  soon  have  become  an  incurable  disease. 
I  do  not  wish  to  offer  any  apology  for  carelessness,  but 
I  have  not  in  this  matter  any  fear  for  it." 
(226) 


The  Prepuce,  Phimosis,  and  Cancer.  227 

In  view  of  the  great  frequenc}^  of  the  occurrence  of 
cancer  of  the  penis,  and  the  facts  pointed  out  by  Roux, 
that,  after  the  removal  of  the  cancerous  prepuce  or  a 
portion  of  the  penis  for  cancer,  in  case  of  a  recurrence 
the  disease  does  not  do  so  in  the  penis,  but  that  it 
attacks  the  inguinal  glands,  showing  conclusively  that 
the  prepuce  is  the  inciting  cause  as  well  as  the  initial 
point  of  attack,  the  sentiments  in  the  foregoing  para- 
graph, taken  from  the  words  of  Hutchinson,  are  worthy 
of  our  most  careful  consideration. 

M.  Roux,  Surgeon  to  the  Gharite,  during  the  second 
decade  of  the  present  century,  first  called  tlie  attention 
of  the  French  profession  to  the  intimate  relation  or  de- 
pendence that  cancer  of  the  penis  bears  to  phimosis. 
In  England  he  was  preceded  in  this  field  of  surgical 
investigation  by  William  Hey,  whom  Roux  met  iu 
London  in  1814.  He}'  had  then  operated  by  amputation 
of  the  penis  on  twelve  cases  of  cancer,  nine  of  whom 
had  had  phimosis  at  the  time  of  the  development  of  the 
cancer.  Wadd  at  this  time  also  published  a  work  on 
the  subject,  but,  although  he  noticed  that  phimosis  was 
a  cause  of  cancer,  he  did  not  fully  grasp  the  subject  as 
He}'  and  Roux  had  done,  as  he  believed  a  cancerous 
diathesis  a  primary  necessity,  and  did  not  then  recog- 
nize that  the  primary  cause  was  fully  to  be  found  in  the 
prepuce  itself, 

Roux  was  probably  the  first  to  point  out  the  peculi- 
arly local  character  of  penile  cancer,  as  there  is  no 
locality  wherein  a  timely  operation  is  less  apt  to  be 
followed  by  a  recurrence.  He  records  a  number  of  cases 
where  the  prepuce  alone  was  affected  when  first  seen,  but 
none  wherein  the  glans  was  attacked  and  where  the 
prepuce  wes  exempt,  giving  ample  evidence  of  the  origi- 
nal starting-point  of  the  disease.^^ 


228  History  of  Circumcision. 

Erichsen  also  remarks  on  the  little  liability  to  recur- 
rence of  cancer  of  the  penis  after  a  timely  operation  ; 
he  divides  the  cancer  to  which  the  penis  is  subject  to  as 
being  of  two  distinct  kinds, — scirrhus  and  epithelioma. 
The  latter  variet}^  commences  as  a  tubercle  in  the  pre- 
puce, and,  according  to  Erichsen,  does  not  occur  in  the 
body  of  the  penis  except  as  a  secondary'  infiltration  or 
deposit.^^  Travers  states  that  Jews  who  are  circumcised 
are  not  subject  to  either  form  of  cancer.^^ 

Repeated  attacks  of  herpes  preputialis  and  some 
consequent  point  of  induration  are  looked  upon  b^"^ 
Petit-Radel,  Chauvin,  and  Bernard  as  frequent  starting- 
points  for  the  cancerous  affection  of  the  prepuce.  The 
aged  or  persons  of  lax  fibre  being  more  subject  to  these 
inflammatory  attacks,  are  also  the  most  frequent  victims 
of  cancer  in  this  situation.  The  celebrated  Lallemand, 
in  regard  to  the  tendency  to  cancer  induced  by  the 
presence  of  the  prepuce,  observes  as  follows  : — 

"  Besides  simple  balanitis  .  .  ,  there  also  result 
various  indurations,  which  are  proportionate  in  their 
degree  to  the  length  of  time  and  intensity  with  which 
the  inciting  inflammatory  conditions  have  existed.  I 
have  repeatedly  found  the  mucous  lining  of  the  prepuce 
thickened,  hardened,  ulcerated,  and  nodulated  ;  at  other 
times  converted  into  a  fibrous  or  even  into  cartilaginous 
tissue  of  excessive  thickness  ;  in  others,  still,  in  which  it 
had  assumed  a  scirrhous  and  cancerous  nature.  I  have 
repeatedly  operated  on  such  cases,  wherein  the  prolonga- 
tion of  the  prepuce  was  the  only  recognized  primar^'^ 
cause,  the  subjects  being  often  countr3anen  of  from  fifty 
to  sixty  years  of  age,  who  had  never  known  an}^  women 
except  their  own,  but  who  had,  nevertheless,  been  long 
sufferers  from  balanitic  attacks,  accompanied  b^'  abund- 
ant acrid    discharges,  swellings  of  the   prepuce,   with 


Tlie  Prepuce,  Phimosis,  and  Cancer.  229 

more  or  less  consequent  excoriations  and  narrowing  of 
tlie  preputial  orifice."^' 

Claparede  sums  up  the  inconveniences  and  dangers 
to  wliich  the  possessor  of  a  prepuce  is  liable  to  suffer 
from,  as  follows  :  "  The  retention  of  the  sebaceous  secre- 
tion is  liable  to  alter  its  character,  converting  it  into  an 
acrid,  irritating  discharge,  which  induces  more  or  less 
burning,  smarting,  itching,  excoriations,  and  swelling, 
which,  affecting  the  little  glands  situated  about  the 
corona  and  sulcus,  induces  them  to  secrete  an  altered 
and  vicious  secretion.  In  this  manner  a  simple  elonga- 
tion of  the  prepuce  will  produce  an  inflammation  of  the 
surface  of  the  glans  (balanitis),  or  that  of  the  prepuce 
itself  (posthitis),  or  the  two  conjoined  (balano-posthitis), 
complicated  possibly  with  phimosis.  By  an  extension  to 
the  mucous  membrane  of  the  urethra  of  the  same  con- 
dition of  the  inflammatory  process,  we  have  blennor- 
rhagia  ;  blennorrhagia  is  liable  to  be  followed  by  inguinal 
swellings  or  tenderness,  orchitis,  stricture,  and  prostatic 
disease  ;  the  formation  of  preputial  calculus,  from  reten- 
tion of  the  urine  in  the  prepuce ;  and  cancer  is  apt  to  be 
the  end  of  any  of  these  conditions." ^^ 

J.  Royes  Bell,  in  Ashhurst's  "  International  Ency- 
clopsedia  of  Surger}^,"  observes  as  follows  :  "  Carcinoma 
attacking  the  genital  organs  usually  assumes  the  form 
of  epithelioma ;  the  other  kinds  are  rarel3^  met  with. 
Epithelioma  may  invade  the  prepuce,  or  the  whole  penis, 
or  any  part  of  it.  The  most  common  age  for  it  is  fifty 
3'ears  or  over.  In  the  great  majority  of  cases  there  has 
existed  a  congenital  or  acquired  phimosis.  A  contusion 
or  a  urinary  fistula  may  be  the  exciting  cause.  With  a 
phimosis  the  parts  are  not  kept  clean,  but  the  gland  is 
macerated  and  rendered  tender  and  excoriated  by  re- 
tained secretions,  and  the  irritation  causes  an  epithelioma 


230  History  of  Circumcision. 

to  grow  in  those  predisposed  to  the  disease,  as  is  found 
to  be  the  case  when  the  tongue  is  irritated  by  a  brolcen 
tooth,  or  the  scrotum  by  the  presence  of  soot  in  its 
folds.  Syphilis  has  no  direct  influence  in  inducing  the 
disease,  but  a  syphilitic  chap  or  ulcer  may  be  the  starting- 
point  of  an  epithelioma.  Two  kinds  of  epithelioma 
affect  tlie  penis, — the  indurated  and  the  vegetating,  or 
cauliflower  growth.  .  .  .  The  nature  of  the  disease, 
in  either  the  prepuce  or  the  glans,  is  masked  hy  a  phi- 
mosis. .  .  .  The  prognosis  in  these  cases  is  much 
more  hopeful  than  in  epithelioma  in  other  situations. 
Sir  William  Lawrence  operated  on  a  patient  who 
was  quite  well  years  afterward,  and  Sir  William  Fergu- 
son amputated  the  penis  of  a  man  of  note  in  the  political 
world,  who  lived  many  years  after  the  operation,  and 
died  at  an  advanced  age." 

Agnew,  of  Philadelphia,  describes  an  epithelioma  of 
the  prepuce  occurring  in  persons  past  middle  life,  begin- 
ning as  a  tubercle,  crack,  or  wart,  for  which  he  advises 
an  early  circumcision  ;  he  admits,  however,  to  not  hav- 
ing sufficient  data  to  determine  whetlier  Jews  and 
circumcised  persons  are  exempt  from  carcinoma  of  the 
penis ;  but  as  its  usual  starting-point  he  evidently 
admits  to  be  in  the  prepuce,  circumcision  must  cer- 
tainly^ be  a  preventive  to  its  appearance.  Gross  gives 
substantial!}'  the  same  opinion  as  Agnew  in  this  regard. 
Dr.  John  S.  Billings,  in  his  article  on  the  "  Yital  Statis- 
tics of  the  Jews,"  in  the  January  North  American 
Review^  of  1891,  on  the  subject  of  cancer,  observes  as 
follows : — 

"  As  regards  cancer  and  malignant  tumors,  we  find 
that  the  deaths  from  these  causes  among  the  Hebrews 
occur  in  about  the  same  proportion  to  deaths  from 
other  diseases  as  they  do  in  the  average  population. 


The  Prepuce,  Phimosis,  and  Cancer.  231 

But  fis  the  ratio  of  deaths  to  population  is  less  among 
the  Jews,  so  the  ratio  of  deaths  from  malignant  diseases 
to  population  is  also  less.  Among  the  living  population 
the  proportion  found  affected  with  cancer  among  the 
Jews  was  6.48  per  1000,  while  of  those  reported  sick  by 
the  United  States  census  of  1880,  for  the  general  popu- 
lation, the  proportion  was  10.01  per  1000." 

There  are  no  convenient  data  as  to  the  prevalence 
or  percentage  of  cases  of  cancer  among  the  Arabian  or 
Mohammedan  population  of  Asia  and  Africa,  but  the 
above  comparison  of  6.48  per  1000  among  the  Jews  of 
the  United  States,  against  10.01  per  1000  of  the  general 
population,  shows  that  the  circumcised  race  does,  in  the 
instance  of  cancer,  certainly  enjoy  a  certain  amount  of 
immunity,  having  in  this  regard  not  quite  such  an 
exemption  as  the}'  enjo}^  from  consumption,  but  still 
sufficient  to  assist  in  making  them  longei'-lived  and 
more  able  to  enjoy  life  and  die  a  less  lingering  and 
painful  death. 

It  is  surprising  that,  in  view  of  the  fact  that  carci- 
noma of  the  penis,  starting  with  such  frequencj'  in  the 
prepuce,  should  have  left  any  doubt  but  that  with  the 
absence  of  this  appendage  there  would  follow  less 
liability  to  cancer.  Cullerier  informs  us  that  he  had 
several  times  amputated  the  penis  for  cancerous  diseases, 
but  that  he  is  unable  to  tell  us  whether  the  persons 
were  affected  with  phimosis,  remarking  that  on  the  last 
case  he  had  observed  the  indurated  remains  of  the  pre- 
puce; he  had,  however,  recognized  the  necessity  of 
freely  exposing  the  gland  in  cases  where,  from  con- 
tinued irritation  and  inflammation,  there  was  danger  of 
cancer  formation. 

Nelaton  describes  two  varieties  of  cancer  that  affect 
the  penis, — that  which  attacks  the  integument  and  that 


232  History  of  Circumcision. 

■which  attacks  the  gians.  The  first  of  these  varieties  he 
observes  as  geuerallj'  beginning  as  a  hardened  nodule  in 
the  prepuce,  which  becomes  at  once  more  or  less  thick- 
ened and  indurated.  He  gives  Lisfranc  the  credit  of 
pointing  out  the  fact,  that,  even  in  the  most  hopeless- 
looking  case,  the  glans  and  body  of  the  penis  ma}^ 
be  siniplv  pushed  back  and  compressed,  but  otherwise 
sound,  and  that  before  resorting  to  an  amputation  of 
the  whole  organ  it  is  better  to  make  a  careful  explora- 
tory- dissection  in  search  of  the  penis,  as  it  oftentimes 
happens  that  the  prepuce  and  integument  can  be  dis- 
sected oft',  leaving  the  organ  intact.  He  also  mentions 
that  elephantiasis  of  the  penile  integument  generally 
begins  in  the  prepuce. 

Baron  Boyer  believed  that  the  vitiated  preputial 
secretion  allowed  to  remain  beneath  the  prepuce  was 
one  of  the  causes  of  cancer  of  the  penis,  observing  that 
it  would  be  interesting  to  know  whether  cancer  of  the 
penis  was  a  rarit}'  among  circumcised  people,  such  as 
the  Jews  and  Mohammedans.^^ 

It  is  easy  to  perceive  why  or  how  Agnew,  Gross, 
Cullerier,  and  manj-  of  those  who  have  written  on  the 
subject,  have  failed  to  appreciate  the  existence  of  the 
prepuce  as  an  exciting  cause,  or  as  being,  in  the  majority 
of  instances,  the  part  primarily  attacked.  The  nodule, 
excoriation,  or  abrasion  that  develops  into  a  cancer 
generall}-  produces  more  or  less  local  disturbance ;  in 
man}^  it  produces  a  phimosis  that  is  only  relieved  by  the 
uIceratiA'e  process  that  exposes  the  gland,  which  may  by 
that  time  itself  be  attacked  or  even  destro^'ed.  They 
are  then  seen  by  either  the  rural  practitioner  or  the  family 
ph^-sician,  but  before  submitting  to  an  operation  thej' 
run  the  gauntlet  of  manv  physicians,  and,  when  it  comes 
to  operating,  they  generally  apply  to  some  one  of  great 


The  Prepuce,  Phimosis,  and  Cancer.  233 

skill  and  reputation.  B3-  this  time  there  is  little  left 
of  the  organ,  and,  as  a  rule,  the  party  is  unable  to  tell 
where  the  disease  originated,  whether  in  the  prepuce  or 
glans,  to  them  the  swollen  prepuce  seeming  to  be  the 
whole  organ.  Of  late  j-ears,  however,  it  has  been  pretty 
well  established  that  it  generally  begins  in  the  preiDuce, 
and  the  great  number  of  amputations  of  the  penis  on 
record  for  this  disease  does  not  lead  one  to  believe  that 
it  is  as  rare  a  disease  as  was  formerl}'^  believed.  In 
Langenbeck's  Archiv,  Bd.  xii,  1870,  Dr.  Zielewicz  re- 
ports fifty  cases  of  amputation  of  the  penis  by  the 
galvano-cauteiy  loop,  mostly  for  carcinoma,  one  of  the 
fifty  being  for  gangrene  and  one  other  for  a  large  papil- 
lar3'  tumor.  That  one  surgeon  was  able  to  report  fortj'- 
eight  cases  of  carcinoma  or  cancer  that  were  treated  by 
one  special  sj'stem  of  operating  tells  us  plainly  enough 
that  the  unfortunate  possessor  of  a  prepuce,  no  matter 
how  normal  or  unolrjectionable  it  ma}^  seem  to  be  in  the 
prime  of  man's  existence,  or  however  physiologically 
necessary  it  may  be  deemed,  runs  too  many  risks  in 
holding  on  to  his  possessions. 

The  views  set  forth  b}'  Hutchinson  in  the  beginning 
of  this  chapter  are  precisely  those  that  are  held  by  the 
writer,  who  would  even  go  further,  by  adA'^ising  all  such 
as  have,  in  their  youth  or  since,  suffered  with  balano- 
posthitis  in  anj^  degree  or  form,  or  whose  prepuce  shows 
a  tendency  to  elongation  with  age,  to  have  the  same  re- 
moved at  once;  where  the  prepuce  is  not  redundant, 
but  only  tight,  a  slight  operation,  such  as  slitting,  will  at 
once  remove  the  possibility  of  any  future  danger,  without 
keeping  a  man  from  his  business  a  single  day. 

It  may  here  be  remarked  that,  although  always  fa- 
vorabl}'  impressed  with  the  great  benefits  arising  out  of 
circumcision,  nothing  ever  resulted  in  such  a  serious 


234  History  of  Cii^cumcision. 

eonsideratiou  of  the  subject  as  seeing  a  professional 
brother  dying  with  a  cancerous  affection  of  the  penis. 
The  disease  had  originated  in  the  mucous  lining  of  the 
prepuce,  and  when  seen  in  consultation  with  his  attending 
physicians  the  gland  had  alreadj^  disappeared  and  the  in- 
guinal glands  were  affected.  The  man  was  in  the  prime 
of  life,  and,  aside  from  the  local  trouble,  a  specimen  of 
perfect  health  and  plij^sique.  He  informed  lis  that  while 
a  youth  he  had  suffered  from  repeated  attacks  of  herpes 
preputialis  ;  that  he  had  suggested  circumcision  more 
than  once  to  his  father,  who  also  was  a  physician, 
but  who,  unfoi'tunatel}^  for  the  son,  could  not  see  any 
merit  In  circumcision.  To  his  ej'es  there  was  nothing 
that  circumcision  could  do  but  what  could  be  accom- 
plished b}'^  washing  and  personal  attention  to  cleanli- 
ness. When  older,  the  prepuce  gave  him  less  trouble, 
and  for  a  long  time  after  his  marriage  it  ceased  to  trouble 
him  altogether.  The  idea  of  the  necessity  of  circum- 
cision did  not  occur  to  him  again  until  the  appearance 
of  the  cancerous  disease;  even  then,  not  appreciating 
the  danger,  and  looking  upon  the  trouble  as  a  simple 
transient  result  of  some  inflammatory  action,  he  waited 
until  the  parts  would  be  in  a  better  state  or  condition 
of  health  before  resorting  to  an  operation, — that  time 
never  came. 

Although  to  Koux,  Wadd,  and  He}^  the  credit  must 
be  given  for  bringing  the  subject  of  cancer  of  this  organ 
so  prominently  before  the  profession,  the  knowledge  of 
the  existence  of  the  disease  has  long  been  a  matter  of 
record.  Patissier,  in  the  fortieth  volume  of  the  "  Diet, 
des  Sciences  Medicales,"  quotes  from  the  third  volume 
of  the  "  Memoires  de  I'Academie  Royale  de  Chirurgie," 
that  in  1724  an  officer,  aged  fifV?  "^^s  attacked  hy  a 
cancerous  atTection  originating  underneath  the  prepuce ; 


Tlie  Prepuce^  Phimosis,  and  Cancer.  235 

at  the  time  he  consulted  MM.  Chicoineau  and  Sonlier 
the  disease  had  existed  for  two  years,  the  inguinal 
glands  were  implicated,  and  even  the  suspensory  ligament 
was  affected.  These  surgeons,  nevertheless,  determined 
upon  an  operation,  and,  after  a  long  chapter  of  haemor- 
i'hagic  accidents,  the  patient  finally  made  a  recovery. 
Another  case,  quoted  by  Patissier,  was  operated  upon 
by  M.  Cej'rac  de  la  Coste,  the  patient  a  man  of  sixty, 
the  disease  originating,  like  the  preceding  case,  under- 
neath the  prepuce. 

Warren,  in  his  "  Surgical  Observations  on  Tumors," 
observes  that  cancer  of  the  penis  begins  by  a  warty 
excrescence  on  the  glans  or  prepuce.  Walshe,  in  his 
work  on  the  "  Nature  and  Treatment  of  Cancer,"  says : 
"  The  disease  may  commence  in  almost  all  parts  of  the 
organ,  but  the  glans  and  prepuce  are  by  far  its  most 
common  primary  seats.  It  may  originate  either  from 
a  warty  excrescence  or  a  pimple,  or  it  may  infiltrate 
the  glans,  or  appear  as  a  complication  of  venereal 
ulceration.  Phimosis,  either  congenital  or  acquired, 
is  an  exceedingly  common  accompaniment,  and  it 
appears  probable  that  the  irritation  occasioned  by  this 
condition  of  the  parts  may  act  as  an  exciting  cause  of 
the  disease  in  persons  predisposed  to  cancer.  Circum- 
cision is,  therefore,  an  advisable  prophylactic  measure, 
where  the  constitutional  taint  is  known  to   exist." 


CHAPTER  XXI. 
The  Prepuce  and  Gangrene  of  the  Penis. 

Another  accompaniment  of  that  preputial  append- 
age is  gangrene  of  the  penis,  which,  like  carcinoma, 
starting  in  at  the  prepuce,  may  invade  the  pubes  and 
scrotum.  This  disease  is  not  so  rare  as  to  merit  the 
little  attention  it  has  received  from  our  text-books. 
M.  Demarquay  has  collected  the  history  of  twenty-five 
cases;  from  him  we  learn  that  the  prepuce  is  the  most  fre- 
quent seat  of  the  start  of  the  affection,  from  whence, 
according  to  Astruc,  it  rapidly  spreads  to  the  skin  of 
the  whole  organ,  and  then  attacks  the  corpora  caver- 
nosa; it  may  even  extend  as  high  as. the  umbilicus. 
This  disease  spares  no  age ;  it  attacks  young  and  old 
alike. 

There  is  not  a  case  recorded  of  this  disease  that 
particularized  any  other  starting-point  than  the  swell- 
ing, tension,  active  or  passive  congestion  that  takes 
place  in  the  integument  of  the  penis.  By  this  it  must 
not  be  understood  that  the  initial  disease  or  inflamma- 
tory action  that  produces  the  gangrene  must  necessarily 
have  its  seat  in  the  integument,  but  that  it  is  the  in- 
tegument of  the  penis  (and  especially  that  of  the  pre- 
puce) in  which,  through  the  laxity  of  its  tissues,  pas- 
sive congestion  is  favored  that  the  gangrenous  action 
begins.  That  this  is  the  actual  case  there  can  be  but 
little  doubt  about,  as,  even  where  the  gangrene  invades 
the  body  of  the  penis  itself,  even  where  the  inflamma- 
tor}^  action  may  have  started  from  a  violent  urethritis, 
that  condition  of  blood  which  favors  gangrenous  results 
(236) 


J7)e  Prepuce  and  Gangrene  of  the  Penis.         237 

will  be  found  to  have  begun  during  its  state  of  stasis, 
where  it  has  parted  with  much  of  its  watery  element,  as 
well  as  considerable  of  its  vitality,  while  in  its  slow, 
tedious,  and  obstructed  passage  through  the  prepuce. 
Some  of  this  dark,  thickish  blood,  finding  its  way  from 
the  integumentary  return  circulation  to  that  of  the 
deeper  structure,  becomes  there  a  mechanical  as  well  as 
a  pathological  cause  for  that  impediment  to  the  free 
circulation  of  the  parts,  through  its  altered  physiologi- 
cal condition.  The  deeper  structures  of  the  penis, 
besides  tlieir  own  blood-suppl}^,  carry  back  into  the 
deeper  or  S3-stemic  circulation  a  large  supply  from  the 
integumentary  tisses,  when  in  the  latter,  owins:  to  the 
greater  supply  due  to  any  inflammatory  action,  the 
blood-current  is  delayed  and  impeded  in  its  lax  and 
easily -dilatable  tissues,  and  blood-changes  occur  favoring 
the  gangrene  in  the  deeper  tissues  ;  so  that,  whether  the 
gangrene  first  takes  place  in  the  body  of  the  penis  or 
in  the  scrotum,  it  will  be  in  the  prepuce  or  adjoining  in- 
tegument that  its  real  originating  causes  will  be  found. 
Baron  Boyer,  in  speaking  of  the  inflammation  of 
the  penis,  observes  that  the  intensity  of  tlie  swelling, 
great  pain,  and  difficulty  of  urination  that  follow  have 
led  many  to  believe  that  the  inflammation  of  the  deeper 
structures  really  always  formed  a  part  of  the  disease. 
In  otherwise  healthy  and  vigorous  subjects  it  does  not, 
however,  extend  beyond  the  skin,  as  has  been  demon- 
strated where  the  resulting  gangrene  from  excess  of 
inflammatory  action  has  ended  in  resolution,  the  deepei' 
tissues  not  having  been  found  to  be  injured.  It  is 
only  where  the  tone  of  the  general  sj'stem  is  lowered, 
through  disease,  age,  or  other  deteriorating  conditions, 
that  the  whole  organ  is  liable  to  become  aflected  or 
to  break  down. 


238  History  of  Circumcision. 

Bo3'er,  in  the  tenth  volume  of  his  "  Treatise  on  Sur- 
gical Affections,"  gives  several  examples  of  this  affec- 
tion not  due  to  age  :  one  case  was  a  person,  simultane- 
ously attacked  by  an  adynamic  fever  and  a  blennor- 
rhagia,  who  suffered  from  gangrene  of  the  penis  ;  the 
local  and  constitutional  disturbance  was  not  high,  how- 
ever, and  the  patient  escaped  with  the  simple  loss  of 
the  prepuce. 

Another  case  admitted  to  the  Charite,  aged  thirty-six, 
was  afflicted  with  a  blennorrhagia,  upon  which  an  attack 
of  low  fever  supervened.  The  penis  inflamed,  became 
engorged  and  livid,  and  soon  gangrenous  symptoms  pre- 
sented themselves,  making  rapid  progress ;  at  first  the 
integument  alone  was  affected,  but  later  all  the  structures 
became  implicated  and  the  penis  was  completely  de- 
stro^^ed,  the  sloughs  detaching  themselves  in  shreds, 
leaving  a  conical  stump  that  healed  but  slowly. 

One  case,  a  young  man  of  twenty,  also  at  the  Charite, 
was  admitted  with  adynamic  fever ;  a  few  days  after 
admission  the  prepuce  was  observed  to  be  somewhat  in- 
flamed ;  in  spite  of  all  treatment  this  progressed  so 
rapidl}^  that  the  purple  discoloration  presaged  a  gan- 
grene, which  was  not  slow  in  following ;  the  focus 
seemed  to  be  at  the  superior  and  back  portion  of  the 
prepuce;  an  incision  evacuated  a  quantity  of  purulent, 
serous  fluid ;  the  disease,  however,  extended  up  the 
organ  as  far  as  its  middle  before  its  actions  ceased  ;  the 
sloughs  were  then  cast  off,  when  it  was  found  that  part 
of  the  gland  and  a  portion  of  the  cavernous  body  had 
followed  the' integument  in  the  general  wreck,  subjecting 
the  patient  to  intolerable  pain  during  micturition. 
After  the  recovery  from  the  fever,  the  remaining  portion 
of  the  glaiKl  and  the  mutilated  parts  of  the  cavernous 
body  were  amputated  to  remedy   this   condition;  the 


The  Prepuce  and  Gangrene  of  the  Penis.         239 

patient  subsequently  admitted  to  have  had  a  blennor- 
rhagia  at  the  time  of  his  admission  to  the  hospital. 

The  gangrenous  action  may,  in  proportion  to  the  low 
condition  of  the  patient,  be  as  proportionately  rapid. 
Another  case  from  Boyer,  quoted  from  the  works  of 
Forestus,  relates  how  the  whole  organ  underwent  such 
speedy  disorganization  that  its  liquefied  remains  were 
found  in  a  poultice,  which  had  been  applied  with  a  view 
of  relieving  the  congestion, — a  ver}'  dear  price  to  pay 
for  retaining  the  prepuce,  that  the  exquisite  sensitiveness 
of  the  tactile  faculty  for  enjo3^ment,  resident  in  the 
corona  of  the  gland,  might  not  be  interfered  with. 

Gross  does  not  mention  this  affection  in  his  work  on 
surgery,  dut  Agnew  devotes  considerable  space  to  its 
description,  dividing  the  disease  into  two  forms :  the 
inflammatorj^,  such  as  may  follow  venereal  primary  spres 
or  operations  on  the  penis,  not  excepting  circumcision ; 
and  the  obstructive  variet}^,  such  as  may  follow  embo- 
lism or  any  mechanical  obstruction,  either  purposely  or 
accidentally  applied.  Of  the  latter  he  gives  a  number 
of  quoted  instances  ;  he  only  admits  seeing  one  case, 
tliat  of  an  aged  man  in  the  Pennsylvania  Hospital,  in 
whom  the  disease  was  caused  by  embolism  of  the  dorsal 
artery. 

J.  Roj^es  Bell,  in  the  "  International  Encyclopaedia  of 
Surgery,"  pays  more  attention  to  it  than  any  of  our 
American  authors  ;  mentioning,  among  the  causes  which 
may  give  rise  to  it,  the  exanthemata,  especially  small- 
pox, and  the  poisoning  by  ergot  of  rye  and  erysipelas. 
Among  the  local  causes  he  mentions  phimosis,  para- 
phimosis, and  balano-posthitis. 

Bell  quotes  the  case  reported  by  Mr.  Partridge,  in 
the  sixteenth  volume  of  the  "  Transactions  of  the  Patho- 
logical Society-  of  London,"  wherein  a  sober  man,  aged 


240  History  of  Circumcision. 

fort}'^,  lost  the  whole  of  his  penis  up  to  the  root,  during 
the  course  of  a  typhus  fever.  Also  the  case  reported  by 
Mr.  Gay,  in  the  thirtieth  A'olunie  of  the  same  "  Trans- 
actions," wherein  a  cabinet-maker,  aged  thirty-one,  lost 
his  penis  through  the  probable  results  of  rheumatic 
phlebitis,  and  due  to  the  presence  of  a  plug  in  the  in- 
ternal iliac  vein.  In  the  twelfth  volume  of  the  "  Trans- 
a(;tions"  of  the  same  society  he  finds  the  record  of  the 
case  of  a  soldier  who  lost  his  penis  through  gangrene 
induced  by  syphilitic  phagedena. 

In  the  consideration  of  the  subject  of  the  prepuce 
as  connected  with  penile  gangrene,  it  must  not  be  over- 
looked that  the  presence  of  a  prepuce  rsMiy  be  the  inciting 
cause  of  some  rheumatic  affection  (the  writer  has  re- 
peatedly seen  such),  just  as  such  cases  are  often  the 
result  of  stricture ;  as  cases  of  rheumatism  that  have 
resisted  all  remedial  means,  but  that  have  readilj'  given 
way  to  the  dilatation  of  a  stricture,  are  by  no  means 
uiicommon  ;  not  a  mere  muscular  reflex  rheumatic  pain, 
but  even  when  accompanied  hy  a  rheumatic  blood  con- 
dition. So  that  even  in  such  a  case  as  above  reported 
as  being  due  to  rheumatic  phlebitis,  or  the  case  reported 
in  the  fortieth  volume  of  the  "  Dictionaire  des  Sciences 
Medicales"  by  Patissier,  wherein  a  man  lost  penis  and 
scrotum  through  gangrene,  induced  by  urinous  infiltra- 
tion, ma}-  all  in  the  origin  be  due,  if  not  to  the  immediate, 
to  the  remote  eflfects  of  the  presence  of  the  prepuce. 

In  the  first  volume  of  the  Journal  of  Venereal  and 
Cutaneous  Diseases  the  writer  reported  a  case  of  the 
complete  loss  of  penis  in  a  j'oung  man  as  a  result  of 
])hagedena  due  to  sj^philis.  The  man  had  had  a  long 
and  pendulous  prepuce  ;  in  his  case,  had  circumcision 
))een  performed  in  early  childhood,  it  would  have  les- 
sened the  chances  of  primar}^  infection  ;  and  had  it  been 


Tlie  Prepuce  and  Gangrene  of  the  Penis.         241 

performed  after  his  infection,  it  "would  have  removed 
one  cause — if  not  the  principal  cause — of  the  ease  with 
which  the  phagedenic  action  was  inaugurated.  The  case 
already  mentioned  as  an  example  of  spontaneous  and 
natural  circumcision  belongs  to  tlie  gangrenous  results 
following  phimosis,  ending  witli  the  loss  of  the  pre- 
puce. In  Maclise's  "  Surgical  Anatomy  "  several  speci- 
mens of  deformity  are  figured,  showing  the  results  of 
this  mildest  of  the  effects  of  a  phagedenic  action.  The 
beginning  of  the  interference  in  the  return  preputial 
circulation  undoubtedly  always  takes  place  over  the 
superior  aspect  of  the  corona,  where  the  pressure  of  the 
glans  is  most  sharpl}^  defined  against  the  inner  fold  of 
the  prepuce. 

There  are  milder  conditions,  wherein  the  circulation 
of  the  prepuce  is  materially  interfered  with,  both  through 
the  lax  tissues  of  the  parts  and  the  peculiar  anatomical 
construction  and  shape  of  the  neighboring  parts,  wherein, 
without  going  as  far  as  gangrenous  breakdown,  the 
person  suffers  considerably  nevertheless,  and  is  placed 
in  danger  of  losing  Ms  penis  ;  for,  as  observed  by  Patis- 
sier,  whenever  a  person  affected  with  a  gonorrhoea  is 
attacked  by  a  putrid  or  any  low-grade  fever,  he  runs 
the  greatest  danger  of  losing  his  virile  member  through 
gangrene. 

Even  where  phimosis  does  not  exist,  but  only  the 
long,,  lax,  and  retractable  prepuce,  that  is  considered  a 
perfectly  physiological  condition,  the  prepuce  is  liable 
to  cause  very  distressing  and  complicating  annoyances 
during  the  progress  of  other  diseases.  The  writer  has 
noticed  that  cases  with  a  thick,  leathery,  and  redundant 
prepuce,  even  when  perfectly  retractable,  are  more  liable 
to  require  the  use  of  the  catheter  during  the  course  of 
a  continued  fever.     Such  a  condition  is  also  a  very  fre- 


242  History  of  Circumcision. 

quent  accompaniment  of  prostatic  obstruction.  So  often 
lias  this  been  noticed  that  its  association  with  prostatic 
trouble  or  disease  tends  to  the  belief  tliat  the  irritation 
produced  by  this  condition  of  prepuce  often  lays  the 
founda,tion  for  prostatic  disease  in  not  a  few  cases,^"" 
In  elderly  people,  with  the  atrophied  penis  and  elongat- 
ing prepuce,  the  constant  moisture  from  the  urine  on 
the  innner  fold  and  glans  adds  greatlj^  to  the  irritation 
as  well  as  to  the  discomfort  of  the  patient. 

A  number  of  affections  are  accompanied  hy  oedema, 
especially  toward  the  latter  stages  of  the  disease  ;  such, 
for  instance,  as  the  ending  of  cases  of  mitral  insuf- 
ficiencj'.  lu  these,  the  distension  of  the  prepuce  and 
the  resulting  balano-posthitis  is  at  times  a  source  of 
great  distress,  and  at  times  the  resulting  engorgement 
produces  a  retention  of  urine.  It  w^as  after  an  attend- 
ance on  one  such  case  that  required  dailj'  and  frequent 
puncturings  for  its  relief,  but  which,  in  spite  of  all  care, 
finally  became  gangrenous,  that  a  fellow  practitioner 
cheerfully  submitted  to  circumcision,  to  avoid  the  pos- 
sil)ilit3^  of  any  such  complication  occurring  to  embitter 
his  closing  illness. ^"^ 

The  prepuce  is  the  starting-point  of  many  of  the 
cases  of  penitis  and  retention  of  urine  that  often 
accompany  attacks  of  gonorrhoea  ;  especially  can  this 
result  be  anticipated  where  the  prepuce  is  long,  pendu- 
lous, and  with  its  veins  in  a  varicose  condition.  Why 
it  should  be  so  is  self-evident.  Anything  that  will  add 
to  the  interference  of  the  return  circulation  only  exag- 
gei'ates  the  tendency  to  penis  engorgement ;  this 
increases  the  difficult}'^  of  urination,  which,  by  the  reten- 
tion that  results,  in  turn  increases  the  constriction  at 
tlie  root  of  the  penis,  and  adds  to  the  already  difficult 
return  circulation.     The  bladder  by  its  urine,  and  the 


Tlie  Prepuce  and  Gangrene  of  the  Penis.         243 

penis  by  its  blood,  actually  form,  by  their  rautual  press- 
ures, an  Impassable  dam  at  the  root  of  the  organ.  That 
this  is  the  true  condition  has  been  more  than  once 
verified  from  the  instant  relief  given  to  the  whole  con- 
dition b}''  the  prompt  employment  of  the  supra-pubic 
puncture  or  aspiration,  as  catheterization  in  such  cases 
is  altogether  out  of  the  question,  and  should  never  be 
attempted  or  employed  unless  a  soft  catheter  can  be 
inserted. 

A  person  laboring  under  a  continued  fever  has  his 
blood  in  a  condition  to  favor  sphacelus  ;  with  the  slow- 
moving  current  of  vitiated  blood  and  its  retention  in  such 
las.  tissues  as  those  of  the  prepuce,  through  the  medium 
of  the  enlarged  preputial  veins,  coupled  with  the  lessened 
sensibilities  of  the  bladder  and  his  perhaps  semi-conscious 
or  unconscious  condition,  and  an  equally  unconscious 
bladder,  he  is,  to  saj^  the  least  of  it, — if  in  possession  of 
a  prepuce, — also  the  unconscious  possessor  of  a  certain 
degree  of  percentage,  no  matter  how  small  or  fractional 
that  ma}^  be,  of  recovering  from  his  fever  without  his 
penis.  Dr.  W.  "W.  McKay,  of  the  U.  S.  Marine  Hos- 
pital Service  of  San  Diego,  attended  a  case  of  typho- 
malarial  fever  in  consultation  with  me,  where,  but  for 
the  persistent,  intelligent,  but  delicate  use  of  the 
catheter  for  nearly  three  weeks  the  penis  would 
have  become  gangrenous.  The  subject  was  an  ursemic, 
irritable,  nervous,  leatherj^-prepuced  individual;  the 
organ  was  unusuall3'  large,  the  skin  of  the  penis  thick, 
and  it  was  only  by  keeping  the  bladder  empty  that  pre- 
vented a  state  of  engorgement  that  would  have  effect- 
ually interfered  with  further  catheterization.  As  it  was, 
the  penis  was  often  dank,  livid,  and  discolored  from  the 
passive  engorgement. 

The  writer  saw  a  similar  case  with  the  late  Dr.  F.  H. 


244  History  of  Circumcision. 

Milligan,  of  Minnesota.  The  congestion  in  this  case  was 
due  to  a  gonorrhoeal  inflammation  involving  the  skin  of 
the  whole  penis,  retention  having  followed  painful  mic- 
turition, and  the  swelling  of  the  penis  following  the  reten- 
tion ;  the  prepuce  was  enormously  distended,  and  the  penis 
seemed  in  a  state  of  erection  as  far  as  dimension  and 
rigidity  were  concerned.  The  man,  a  steam-boat  cook,  in- 
formed us  that  it  was  fully  twice  as  large  as  when  rigidl}' 
erect  in  health.  All  eflTorts  to  reduce  the  swelling  were 
unavailing;  neither  punctures, leeches,  nor  scarifications 
were  of  any  avail ;  catheterization  was  impossible,  but, 
after  relieving  the  bladder  by  the  supra-pubic  aspiration, 
the  patient  experienced  some  relief.  He,  nevertheless, 
lost  the  whole  skin  of  the  penis,  with  that  of  the  pubis 
and  on  the  front  of  the  scrotum.  The  man  ran  into  a 
low  form  of  fever,  with  ursemic  symptoms ;  the  stench 
was  so  great  that  it  was  almost  impossible  to  remain  in 
the  same  room  with  him  ;  but  he  finally  made  a  slow 
and  very  tedious  recovery.  In  healing  there  was  con- 
siderable downward  curvature  of  the  penis,  which, 
however,  did  not  prevent  him  from  following  his  old, 
dissolute  course  of  life. 

A  calm,  unprejudiced  consideration  of  the  subject  of 
the  liability  of  the  uncircumcised  races  dwelling  in  the 
temperate  and  semi-tropical  countries  to  cancer,  gan- 
grene, and  elephantiasis  might  well  lead  one  to  ask  :  Why 
are  we  afflicted  with  a  prepuce  ?  We  can  understand 
how  a  man  may  become  gouty,  and  become  a  subject  in 
the  end  for  a  gangrene  of  the  extremities  ;  or  how  senile 
gangrene  may,  through  a  series  of  pathological  proc- 
esses and  blood  changes,  with  the  aid  of  age,  finally  be 
reached  ;  or  how,  by  a  like  course  of  diseased  pi'ocesses, 
we  reach  the  apoplectic  stage.  These  conditions,  how- 
ever, can  be  put  off,  or  partly,  if  not  wholly  avoided,  by 


The  Prepuce  and  Gangrene  of  the  Penis.         245 

a  proper  course  of  life,  and,  at  the  worst,  it  is  only  after 
tlie  fires  of  our  youth  and  prime  have  complete!}^  burned 
out,  that  these  conditions  are  liable  to  claim  us  as  their 
lawful  victim.  Not  so,  however,  with  some  of  these  con- 
ditions that  may  end  in  penile  gangrene  ;  that  are  liable 
to  pounce  upon  us  unawares,  like  an  Apache  in  an  Ari- 
zona canon  ;  or  as  the  hired  mercenaries  of  old  Canon 
Fulbert  did  upon  poor  Abelard  in  his  study,  and,  without 
further  ado  or  cei'euiony  emasculate  man  as  effectuallj- 
as  the  most  exacting  Turk  could  demand,  with  a  veri- 
table taille  a  fleur  de  ventre  operation. 

Nature  has  her  own  ways  of  protecting  what  there  is 
of  any  utility ;  there  is  a  law  of  the  survival  of  the 
fittest  that  we  all  appreciate.  If,  then,  this  penile  ap- 
pendage is  of  any  utility,  why  is  it  that,  unlike  the 
rest  of  the  body,  it  falls  such  an  easy  Aactim  to  gan- 
grene ?  The  procreative  function  seems  to  be,  in  a  sense, 
one  of  the  main  cares  of  nature  in  its  relation  to  the 
animal  as  well  as  the  vegetable  kingdom  ;  but  here  is  a 
useless  bit  of  skin,  adipose  tissue,  mucous  membrane, 
and  some  connective  tissue,  that  on  the  least  provoca- 
tion is  liable  to  go  off  into  a  gangrene  and  drag  one  of 
the  main  generative,  or  even  all  the  procreative,  appa- 
ratus into  the  general  wreck.  Nature  certainly  never 
intended  anj^thing  of  the  kind.  To  be  generous,  and  not 
libel  nature,  we  must  conclude  that  the  prepuce  is  a 
near  relative  to  the  fast-disappearing  climbing-muscle; 
very  useful  in  our  primitive,  arboreal  days,  when  we 
needed  such  a  muscle  to  reach  our  perch  for  the  night, 
and  a  prepuce  or  something  of  the  kind,  in  default  of 
a  breech-cloth,  to  protect  the  glans  penis  from  being 
scratched  by  the  briars  or  thorny  and  rough  bark  of  the 
trees  in  our  ascent.  The  prepuce  was  well  enough  in 
our  primitive  and  arboreal  days,^-ages  and  ages  ahead 


246  History  of  Circumcision. 

of  our  cave  and  lake  dwellings, — wlien  the  noteli  in  a 
tree  and  its  rough  bark  formed  our  couch  ;  but  in  these 
days  of  plush-cushioned  pews  and  opera-seats,  cosy 
office-chairs,  car-seats,  and  upholstered  furniture  or 
polished-oak  seats,  it  serves  no  intelligent  purpose. 

Emasculation  has  never  been  looked  upon  with  favor 
by  its  victim,  and  it  would  be  but  natural  to  suppose 
that  man  would  take  every  precaution  against  the  acci- 
dental occurrence  of  such  an  undesired  condition.  The 
writer  well  remembers  that,  in  his  "Tom  Sawyer"  days 
on  the  banks  of  the  upper  Mississippi,  in  the  bappy  days 
of  the  crack  rafting  crews,  before  the  introduction  of 
the  towage  steamer,  when  the  river  towns  were  more  or 
less  terrorized  by  wild  gangs  of  these  men,  some  of 
whom  were  alwa3^s  fighting  and  quarreling  and  di'inking 
when  not  at  work.  In  the  lot  there  was  one  man  witli 
a  great  reputation  at  a  rough-and-tumble  fight.  His 
main  hold  was  that  he  generally  tried  to  emasculate  his 
adversary  by  destroying  the  physiological  condition  of 
the  testicle.  The  man  was  not  a  large  or  powerful  man, 
nor  was  he  a  great  boxer  or  wrestler,  but  this  reputation 
made  him  feared  by  all  the  bullies  on  the  rivei*.  The 
report  that  not  a  few  who  had  tackled  him  had  subse- 
quently been  of  no  value,  either  as  fornicators  or  feeun- 
dators,  or  had  to  be  castrated  on  account  of  the  resulting 
testicular  degeneration,  seemed  in  no  wa}^  to  encourage 
any  one  to  wish  to  meet  him  in  a  personal  encounter. 
It  would  seem  as  if  the  desire  to  avoid  such  an  accident 
— provided  persons  knew  the  dangers  that  lurk  in  a 
prepuce — would  induce  many  to  submit  to  circumcision. 
That  many  more  do  not  do  so  can  only  be  attributed  to 
the  general  human  wish  to  escape  a  less  present  evil  for 
a  greater  unknown  one,  being  evidently  deterred  hy  the 
prospective  pain  that  must  be  suffered  immediately. 


The  Prepuce  and  Gangrene  of  the  Penis.         247 

There  is  a  question  that  should  interest  man  above 
that  of  the  simple  loss  of  penis.  It  appears  that  there 
is  a  powerful  moral  effect  that  follows  this  loss,  as 
might,  in  the  majority,  be  anticipated.  According  to 
the  experience  of  Civiale,  many  who  have  lost  the  penis, 
through  amputation  for  disease  or  through  disease 
itself,  end  in  suicide.  He  mentions  particularly  a 
patient  at  the  Charite  who  liad  lost  his  penis,  who,  find- 
ing no  other  means  to  take  himself  off,  saved  up  suf- 
ficient opium,  from  that  given  him  to  calm  his  pains,  to 
take  all  at  one  dose  and  commit  suicide.  In  the  London 
Lancet  for  March  27,  1886,  there  is  reported  a  discus- 
sion on  this  subject,  to  which  the  reader  is  referred,  as 
it  fully  covers  the  moral  and  physical  effects  of  castra- 
tion and  penis  amputation  for  disease.  M.  Roux,  who 
amputated  the  penis  of  a  brother  of  Buffon,  in  1810, 
reported  that,  in  that  case,  M.  Buffon  lost  none  of  his 
customary  gayety. 


CHAPTER  XXII. 

The  Prepuce,  Calculi,  and  Other  Annoyances. 

From  an  article  published  in  the  New  York  Medical 
Times  of  March,  1872,  from  the  pen  of  Dr.  J.  G.  Kerr, 
of  Canton,  China,  we  learn  that  phimosis  is  not  an 
uncommon  occurrence  among  the  Chinese.  As  has  been 
demonstrated  by  C.  H.  Mastin,  of  Mobile,  climate  is  a 
great  factor  of  calculus.  ("  Transactions  Internationc'il 
Medical  Congress"  of  1876,  page  609.)  That  of  China 
seems  a  most  favorable  climate  in  this  regard ;  so  that, 
between  the  prevalence  of  phimosis  among  the  Chinese 
and  the  calculus-producing  tendency  of  the  climate,  China 
ma}^  be  said  to  be  the  classic  land  of  preputial  calculi,  as 
England  is  that  of  the  gout,  or  the  TJnited  States  that 
of  delirium  tremens.  From  Dr.  Kerr  we  learn  that  the 
occurrence  of  these  concretions  were,  as  a  rule,  multiple, 
and  that  in  two  cases  that  fell  under  his  observation 
the  number  of  stones  from  each  individual  exceeded 
one  hundred.  In  one  case  there  were  fort}^,  and  in  three 
cases  there  were  between  twenty  and  thirt}'.  These 
were  of  different  sizes  and  weiglit,  some  being  an  inch 
and  five-eighths  in  diameter,  and  from  that  size  down  to 
where  one  hundred  and  sixteen  taken  from  one  indi- 
vidual case  onl}'-  weighed  one  ounce.  The  tendency  to 
calculous  disease  in  that  climate  may  wey  be  imagined, 
when  the  same  observer  relates  a  case  of  urinary  infil- 
tration into  the  skin  on  the  under  side  of  the  penis  that 
gave  rise  to  the  formation  of  a  collection  of  calculi  in 
that  localit}',  four  of  which  were  the  size  of  pigeons' 
eggs ;  and  another  case  in  which  a  urinary  fistula 
(248) 


The  Prepuce^  Calculi,  and  Other'  Anrioyances.     249 

induced  the  formation  of  a  calculus  in  the  groin,  near 
■  the    scrotum,  the    calculus    weighing   two    and  a  half 
drachms  and  measuring  one  and  a  half  inches  by  three- 
quarters  of  an  inch  in  diameter. 

Claparede  mentions  a  case  in  the  practice  of  M. 
Dumeril,  in  which  tlie  stone  extracted  from  the  prepuce 
weighed  two  hundred  and  twentj'-five  grammes,  or 
about  eight  ounces.  Civiale  speaks  of  a  young  man  of 
twenty  with  phimosis,  who,  after  practicing  sexual  con- 
nection for  the  first  time,  experienced  pain  and  a  puru- 
lent discharge,  from  whom,  on  examination,  he  removed 
five  stones  as  large  as  prunes.  The  patient  had  felt 
them  in  their  position,  but  had  imagined  the  condition 
to  be  a  natural  one. 

E.  L.  Ke^'es  gives  their  composition  as  being  of 
calcified  smegma,  urate  of  ammonium,  triple  and  earthy 
phosphates  and  mucus,  and  as  symptoms  and  results  : 
pain,  purulent  discharges,  interference  with  urination 
and  the  sexual  act,  involuntar}'  emission,  ulceration  of 
the  preputial  cavitj',  and  impotence. 

Enoch  mentions  a  child  of  two  years  in  the  Charite, 
who,  being  operated  upon  for  phimosis,  was  found  to 
have  a  preputial  calculus  occluding  the  urethral  meatus. 
At  the  autopsy  a  calculus  as  large  as  an  egg  was  found 
in  the  bladder. 

The  presence  of  these  formations,  although  not 
necessarily  dangerous  in  themselves,  may,  by  their 
effects  and  in  the  irritation  the}'  induce,  be  the  means 
of  producing  serious  mischief.  The  only  preventive  or 
remedy  for  this  condition  is  circumcision. 

Acquired  phimosis  has  been  mentioned  as  a  result 
of  inflammatory  action,  such  as  is  connected  with  balano- 
posthitis  ;  it  sometimes  happens  that,  the  act  of  coitus 
being  done  forciblj-,  especially  with  public  women,  who 


250  History  of  Circumcision. 

are  apt  to  use  very  astringent  and  constricting  waslies, 
tlie  prepuce  becomes  injured,  with  the  result  of  pro- 
ducing a  phimosis.  One  man  will  produce  the  same 
results  through  the  means  of  some  vaunted  wash  or  dip 
which  is  supposed  to  act  as  a  proph3'lactic  to  any  vene- 
real infection.  One  patient  had  developed  a  chronic 
herpetic  affection  by  the  constant  use  of  an  iodized 
ointment  which  he  regarded  as  an  infallible  prophylactic. 
Many  cases  of  phimosis  result  from  the  attending  in- 
flammation that  follows  on  the  liberal  domestic  applica- 
tion of  nitrate  of  silver  to  an  abrasion  after  connection, 
in  the  mistaken  idea  that  the  party  labors  under,  that 
he  is  destro}' ing  some  venereal  virus. 

By  the  irritation  that  all  these  applications  and  acci- 
dents induce,  warts  and  vegetations  are  the  but  too 
frequent  results.  These  I  have  never  seen  in  a  circum- 
cised individual,  and  their  occurrence  and  frequency,  as 
well  as  persistency,  are  directly  proportionate  with  the 
degree  of  tightness,  thickness,  or  redundancy  of  the  pre- 
puce and  the  irritability  of  the  gland.  As  remarked  by 
Lallemand,  in  reference  to  the  victim  of  nocturnal  enu- 
resis becoming  a  future  victim  of  nocturnal  emissions,  so 
it  may  be  said  of  the  person  subject  in  early  life  to  either 
warts,  excoriations  or  vegetations  on  the  penis,  that  it 
is  this  class  that  furnishes  in  after  life  the  subjects  for 
cancerous  disease  as  well  as  furnishing  the  easiest  victims 
for  venereal  infection.  These  warts,  although  easily  re- 
moved, have  a  tendency  to  recurrence,  especially  as  long 
as  the  moist  bed  that  has  once  grown  them  there  is  still 
vegetating. 

The  prepuce  is  liable  to  indurations  and  hj-pertrophy. 
Of  the  first  anonial}^  the  London  Lancet  of  1846  has  a 
record  of  two  cases  in  which  paraphimosis  was  induced 
in  elderly  subjects,  and  of  one  in  which  it  induced  phi- 


The  Prepuce,  Calculi,  and  Other  Annoyances.     251 

mosis.  Since  then  a  number  of  cases  of  thickening  and 
induration  have  been  reported.  Hypertrophy  may  take 
place  in  any  degree,  varying  from  the  mere  leatliery  and 
overpendulous  but  unobstructive  prepuce  to  the  case 
recorded  by  Yidal,  in  the  fifth  volume  of  his  "  Pathologic 
Externe  et  Medecine  Operatoire,"  which  happened  in 
the  practice  of  M.  Rigal,de  Gaillae.  The  hypertrophied 
prepuce  was  something  enormous,  and  hung  down  to 
below  the  patient's  knees  ;  it  was  pear-shaped,  with  the 
base  hanging  downward  ;  this  base  was  as  large  as  a 
man's  head.  This  prepuce  was  successfully  removed  by 
M.  Rigal,  who  presented  the  specimen  before  the  Paris 
Surgical  Society,  who  were  then  discussing  a  somewhat 
similar  but  not  so  extensive  a  case,  presented  by  M. 
Lenoire.  Vidal  mentions  having  operated  on  a  number 
of  cases  of  this  deformity  of  the  prepuce  in  various 
degrees  of  growth. 

As  a  rule,  simple  hypertrophic  disease  of  the  penile 
integument  does  not  interfere  with  the  sexual  func- 
tions of  the  male  organ  after  its  removal ;  it  being  sus- 
ceptible of  complete  removal  in  exaggerated  cases, 
even  without  touching  the  body  of  the  organ.  There 
are  exceptions  to  this  rule,  however,  when  cA^en  this 
otherwise  non-malignant  disease  may  entail  the  loss 
of  all  the  genitals.  In  the  London  Lancet  of  Jul}'  11, 
1846,  at  page  46,  there  is  a  record  of  a  remarkable  case 
of  this  nature  reported  hy  F.  H.  Brett,  Esq.,  F.R.C.S. 
The  case  was  that  of  a  locksmith  of  forty  years  of  age, 
who  was  naturally  much  phimosed.  The  penis  was 
enormously  enlarged,  as  well  as  the  scrotum,  which  was 
more  or  less  ulcerated  and  full  of  sinuses  filled  with  a 
serous  pus ;  some  six  months  prior  to  the  final  operation, 
a  part  of  the  prepuce  was  removed  to  facilitate  urina- 
tion, but  the  whole  mass   had  to  be  subsequently  re- 


252  History  of  Circumcision. 

moved,  including  the  whole  of  the  skin  of  the  penis  and 
the  scrotum,  the  testicles  having  been  carefully  dissected 
out  and  recovered  witli  some  skin  flap. 

In  this  case  the  disease  was  believed  to  have  origi- 
nated from  a  perineal  fistula.  The  pathological  investi- 
gation in  the  case,  however,  by  Mr.  Quekett,  who 
submitted  the  mass  to  a  microscopical  examination, 
confirmed  Mr.  Brett  in  his  original  opinion  that  the  dis- 
ease had  the  same  pathological  conditions  as  the  similar 
disease  found  in  India,  where  it  originates  from  local 
inflammatory  causes.  In  this  case  the  preputial  irrita- 
tion was,  in  all  probability,  the  precursor  of  the  condi- 
tions that  led  to  the  perineal  fistula,  the  patient  having 
had  a  stricture  for  some  twelve  years.  Mr.  Brett  states 
that  the  man  had  been  abandoned  by  his  wife  on  account 
of  his  previous  sexual  disability,  and  on  account,  as 
well,  of  his  having  been  incapacitated  from  following 
any  vocation.  After  the  operation  all  his  functions 
were  restored  and  his  organs  were  sound. 

Nelaton  records  a  case  reported  by  Wadd,  in  1811, 
of  an  African  negro  so  affected,  whose  penis  measured 
fourteen  inches  in  length  and  twelve  and  a  half  inches 
in  circumference;  also  the  case  reported  by  Gibert,  of 
Hospital  St.  Louis,  of  a  subject  "  with  a  penis  the  size  of 
a  mule's." 

Mr.  Brett  attributes  the  recovery  of  his  case  as  being 
due  in  a  great  measure  to  the  moral  support  given  to  the 
patient  from  the  knowledge  that  his  procreative  organs 
were  not  interfered  with,  and  on  the  same  grounds  he 
attributes  the  great  fatality  previously  attending  the 
operation  to  the  fact  that  it  previously  had  been  the 
custom  in  many  cases  to  make  a  clean  general  taille  a 
fleiir  de  ventre^  sacrificing  all  the  genital  organs.  In 
simple  hypertrophy,  he  considers  that  the  body  of  the 


The  Prepuce,  Calculi,  and  Other  Annoyances.     253 

penis  and  the  testicles  will  always  be  fonnd  to  be  in  a 
normal  condition  ;  a  careful  dissection  of  the  parts  will 
invariably  save  not  only  the  man's  sexual  functions,  but 
his  moral  stamina,  which  he  sadly  needs  in  such  an 
emergency.  In  the  discussion  on  this  subject  heretofore 
mentioned  as  taking  place  in  the  London  Medical  Society, 
Mi\  Pye,  Mr.  John  A.  Morgan,  and  others  insisted  on 
the  necessity  of  retaining  the  testicles,  whenever  pos- 
sible, in  all  these  sweeping  operations  upon  the  genitals, 
they  being  actually  necessary  for  the  moral  and  physical 
support  of  man,  Mr.  Morgan  observing  that  their  re- 
moval would  depress  parts  controlled  by  the  sympathetic 
system. 


CHAPTER  XXIII. 

Reflex  Neuroses  and  the  Prepuce. 

We  have  seen  in  the  previous  chapters  what  the  im- 
mediate effects  of  the  prepuce  may  lead  to ;  we  have 
followed  its  local  effects  in  childhood  to  youth,  thence 
into  what  it  does  in  our  prime,  and  we  have  seen  how, 
when  we  are  on  the  down  grade,  owing  to  the  in- 
crease of  3'ears,  then,  like  the  minute-men  of  Concord, 
wakened  up  by  Paul  Revere's  classic  ride,  hanging  on  to 
the  rear  of  the  retreating  and  disheartened  British,  it 
harasses,  worries,  and  downs  a  man  here  and  there, 
striking  down  the  man  as  if  it  had  some  undying,  irre- 
mediable spite,  which  nothing  but  his  misery  and  death 
could  alleviate.  Some  authorities  will  argue  that  all 
that  is  required  is  cleanliness ;  that  all  men  need  do  is 
to  be  like  a  true  American,  with  the  old  Continental 
watchword  of"  eternal  vigilance  is  the  price  of  liberty  " 
in  continued  active  practice.  A  bowlful  of  some  anti- 
septic wash  and  a  small  sponge  should  alwaj^s  be  at 
hand,  and  he  should  be  as  industrious  as  if  haltered  in  a 
tread-mill ;  he  should  make  this  a  part  of  his  toilet,  and 
his  dailj^  and  hourly  cai-e.  This  will,  we  are  told,  lessen 
his  chances  of  becoming  a  victim  to  the  many  ills  that 
lie  in  wait  for  him,  all  on  account  of  the  glory,  honor, 
and  comfort  of  wearing  a  prepuce,  which  is  a  perfectly 
physiological  appendage. 

From  these  visible  and  apparently  easily  understood 

conditions  and  results  we  are  now  to  enter  abroad  field, 

wherein  the  prepuce  seems  to  exercise  a  malign  influence 

in  tlie  most  distant  and  apparently'  unconnected  manner; 

(254) 


Rejiex  Neuroses  and  the  Prepuce.  255 

•where,  like  some  of  the  evil  genii  or  sprites  in  the 
Arabian  tales,  it  can  reach  from  afar  the  object  of  its 
malignity,  striking  him  down  unawares  in  the  most  un- 
accountable manner;,  making  him  a  victim  to  all  manner 
of  ills,  sufferings,  and  tribulations ;  unfitting  him  for 
mai'riage  or  the  cares  of  business  ;  making  him  miserable 
and  an  object  of  continual  scolding  and  punishment  in 
childhood,  through  its  worriments  and  nocturnal  enure- 
sis ;  later  on,  beginning  to  affect  him  with  all  kinds  of 
physical  distortions  and  ailments,  nocturnal  pollutions, 
and  other  conditions  calculated  to  weaken  him  i)h3'sic- 
ally,  mentallj^,  and  morall}'^ ;  to  land  him,  perchance,  in 
the  jail,  or  even  in  a  lunatic  asylum.  Man's  whole  life 
is  subject  to  the  capricious  dispensations  and  whims  of 
this  Job's-comforts-dispensing  enemy  of  man. 

As  strange  as  it  may  seem,  this  fieM  of  knowledge, 
tills  field  of  misery-  and  suffering,  disease  and  distortion, 
of  physical  and  mental  obliquit^^  presided  over  by  this 
preputial  Afrit  of  malignant  disposition,  was  an  un- 
known, undiscovered,  and  therefore  unexplored  region 
for  some  thousands  of  years,  and  it  remained  for  an 
American  to  discover  and  describe  this  vast  territorial 
acquisition,  and  to  annex  it  to  the  domain  of  medicine, 
which,  through  its  skill,  could  modify  the  influence  of 
the  evil  genius  that  there  presided  and  spare  humanity 
much  of  the  ills  to  which  it  had  been  subjected. 

In  this  regard,  Louis  A.  Sayre  was  to  medicine  what 
Columbus  was  to  geograph}'.  Neither  Strabo  nor  Hero- 
dotus had  anj'thing  to  say  regarding  what  existed 
beyond  the  pillars  of  Hercules,  and  neither  Hippocrates 
nor  Galen  had  anything  in  regard  to  this  preputial 
Merlin,  which  in  their  day,  even,  had  its  existence. 
Neither  did  Tissot  nor  Bienville,  the  two  pioneers  in  the 
field  of  our  knowledge  regarding  onanism  and  nj-mpho- 

9 


256  History  of  Circumcision. 

mania,  dream  of  the  existence  of  this  one  cause  of  the 
diseases  to  which  they  gave  so  much  time  and  study. 
It  is  only  some  twenty  years  since  Louis  A.  Sayre  read 
his  paper,  entitled  "  Partial  Paralysis  from  Reflex  Irri- 
tation Caused  by  Congenital  Phimosis  and  Adherent 
Prepuce,"  liefore  the  American  Medical  Association. 
This  was  the  starting-point  from  whence  the  profession 
entered  into  what  had  previously  been  a  veritable 
"  Darkest  Africa." 

When  we  read  that  only  some  fifty  years  before  the 
times  of  Columbus  Christian  Europe  had  no  lunatic 
asylum, — not  that  there  was  a  lack  of  lunatics  or  that  the 
existence  of  lunacy  was  entirely  ignored,  but  that  the 
then  state  of  medicine  and  the  general  intelligence  was 
not  emancipated  from  the  idea  of  demoniacs, — and  we 
are  told  that  the  lunatics  were  in  man}^  instances  hung, 
quartered  and  burned,  hooted  and  chased  about  the 
streets,  or  chained  in  gloomj^  dungeons  ;  until,  as  related 
1)3'  Leckv,  a  Spanish  monk  named  Juan  Gilaberto  Joffe, 
filled  with  compassion  at  the  sight  of  the  maniacs  who 
were  hooted  by  crowds  through  the  streets  of  Yalencia, 
founded  an  asylum  in  that  city.  His  movement  in  this 
direction  called  the  attention  of  the  Church  and  people 
to  this  class  in  a  practical  light,  and  from  Spain  a  more 
enlightened  idea  in  regard  to  this  class  swept  onward 
throughout  Europe.  As  observed, it  seems  strange  to  us 
of  the  present  day  that  such  ignorance  in  these  matters 
should,  or  could,  have  so  long  existed.  It  seems  im- 
possible for  us  to  conceive  how  these  conditions  of  in- 
coherent action  and  of  mental  derangements  could  have 
existed  and  their  causes  have  not  been  fully  appreciated  ; 
and  yet  we  were  not  above,  some  twenty  years  ago  only, 
subjecting  children  to  punishment  and  scoldings  for 
being  addicted   to  nocturnal  enuresis,  or  of  accusing 


Reflex  Neuroses  and  the  Prepuce.  25t 

cases  of  iioctnvnal  and  in voluntaiy  emissions  as  being  due 
to  masturbation.  The  child  was  allowed  then  to  grow  up 
paralytic,  or  with  a  deformed  limb,  or  continually  pun- 
ished to  correct  what  was  imagined  to  be  a  condition  of 
willful  carelessness,  irritability,  or  willful  moral  perver- 
sion. Perversion,  stupidity',  and  irritabilitj'^  of  the  mind 
or  temper  were  not  known  to  depend,  in  manj^  instances, 
on  preputial  irritation ;  children  were,  accordingly, 
worried  and  punished  for  something  over  which  they 
had  no  earthly  control  or  the  least  volition.  Humanity 
cannot,  at  present,  sufficiently  appreciate  what  Louis  A. 
Sayre  has  done  in  its  behalf.  It  is  here  that  we  realize 
the  hidden  wisdom  of  the  Mosaic  law  and  the  truth  of 
the  assertion  of  the  late  Dr.  Edward  Clarke,  that,  "  The 
instructors,  the  houses  and  schools  of  our  country's 
daughters,  would  profit  by  reading  the  old  Levitical  law. 
Tiie  race  has  not  3'et  outgrown  the  physiology  of  Moses." 
These  irritations  from  the  preputial  irritability  are 
not  always  so  slow  moving  as  to  span  over  either  months 
or  years  in  their  fell  work.  Instances  of  their  sudden 
action  have  been  sufficiently  recorded  as  to  warrant 
them  as  being  classed  as  causative  agents  in  acute 
affections  that  instantly  threaten  life.  In  the  London 
Lancet  of  May  16,  1846,  there  is  a  record  of  a  ver}' 
peculiar  case  reported  to  the  London  Medical  Society 
by  Dr.  Golding  Bird  :  "  The  case  was  that  of  a  child  seven 
or  eight  weeks  old  onl3^,an  out-])atient  of  Guy's  Hospital. 
The  child  had  become  almost  lifeless  immediatel3^  after 
nursing,  and  to  all  appearances  looked  as  if  under  the 
influence  of  some  narcotic.  It  had  not,  however,  had 
anything  of  the  kind  given  to  it,  nor  had  it  si-stained  a 
fall,  nor  was  the  head  so  large  as  to  lead  to  suspicion  of 
congenital  hydi'ocephalus.  On  inquiring  if  the  child 
passed  water,  the  answer  led  to  an  examination  of  the 


258  History  of  Circumcision. 

prepuce,  wliicli  was  found  to  be  elongated,  and  liad  an 
aperture  only  of  the  size  of  a  pin-hole,  like  a  puncture 
in  the  intestines.  The  urine  was  dribbling  out;  it  was 
evident  that  the  child  had  never  completely  emptied  its 
bladder.  Mr.  Hilton  slit  up  the  prepuce,  and  all  the 
symptoms  were  immediately  relieved  and  soon  entirely 
removed."  Dr.  Bird  referred  to  a  case  which  he  had 
related  to  the  Society  some  years  before,  which  was  re- 
ported in  the  Lancet  at  the  time,  of  a  child  who  fell  a 
victim  to  a  malformation  of  this  kind,  and  after  death 
the  bladder  and  ureter  were  found  like  those  of  a  man 
wlio  had  long  suffered  from  stricture.  Mr.  Hilton  has 
seen  many  cases  similar  to  the  one  mentioned  by  Dr. 
Bird.  The  greatest  benefit  resulted  from  slitting  up 
the  prepuce.  In  this  case  the  benefit  was  A'ery  remark- 
able, a  partial  paralysis  of  the  left  side,  under  which 
the  little  patient  labored,  being  quite  removed  in 
twenty-four  hours. 

In  this  case  the  difficulty  was  evidently  both  the 
result  of  mechanical  pressure  and  reflex  irritation.  A 
somewhat  similar  case  as  to  its  results  is  given  by  Dr. 
Sayre,  to  whom  the  case  was  reported  by  Dr.  A.  R. 
Mott,  Jr.,  of  Randall's  Island,  in  January  of  1880 : 
"John  English,  aged  46,  native  of  England,  widower, 
clerk;  admitted  to  workhouse  hospital.  Patient  had 
been  at  work  for  a  week  as  a  prisoner ;  on  the  23d  of 
December  was  noticed  to  be  restless  and  uneasy,  and 
finally,  in  the  evening,  he  fell  from  his  bunk  in  a  fit. 
During  the  next  fort^y -eight  hours  he  had  several  con- 
vulsions, and  -during  the  intervals  lay  in  a  semi-comatose 
condition,  showing  no  consciousness  except  to  stir  a 
limb  when  pinched.  Pulse,  120  ;  temperature,  101^°  ; 
respiration,  18.  Swallowed  nothing,  and  passed  fteces 
in  bed.    Continued  in  this  condition  until  December  25th 


Reflex  Neuroses  and  the  Prepuce.  259 

(temperature  having  fallen  to  100°),  when  a  string  was 
discovered  passed  twice  around  the  penis  behind  corona 
and  tied,  the  long  prepuce  serving  to  conceal  it  from  ob- 
servation. While  not  sufficiently  tight  to  occlude  the  ure- 
thral canal,  still  a  firm,  indurated  band  remained  after  the 
string  was  cut,  and  did  not  disappear  for  four  or  five  days. 

"  Within  one  hour  after  the  removal  of  the  string 
the  man  sat  up  and  asked  for  milk,  and  from  this  time 
remained  perfectly  well  (was  under  observation  for 
three  months).  He  declared  that  he  remembered  nothing 
that  had  taken  place  during  the  past  three  days  ;  had 
never  had  fits,  denied  venereal  diseases,  was  moderately 
addicted  to  drink,  but  had  led  a  '  virtuous  life  since  the 
death  of  his  wife,  two  years  before.'  " 

The  following  case  in  the  practice  of  Dr.  F.  J. 
Wirthington,  of  Livermore,  Pa.,  was  also  reported  to 
Dr.  Sayre  :  "  When  the  child  was  born,  he  was  consid- 
ered the  biggest  and  finest  boy  that  had  been  born  in 
the  communitj'  for  a  long  time,  until,  when  he  was  about 
two  and  a-half  years  old,  and  being  sick,  a  doctor  was 
called  in,  who  told  them  that  their  child  was  paralyzed, 
the  paralysis  being  in  his  lower  extremities,  and  who 
treated  him  with 'the  usual  nerve-tonic  and  with  elee- 
tricit3\  Notwitlistanding  all  this,  the  boy  went  steadily 
down,  and  the  paralysis  continued  until  he  was  seen  by 
Dr.  Wirthington.  The  child  was  then  unable  to  walk; 
on  examination,  the  prepuce  was  found  to  be  adherent 
almost  all  the  way  around  the  glans  penis.  Behind  the 
corona  was  a  solid  cake  of  sebaceous  matter.  The  case 
was  promptly  operated  upon,  and,  although  the  previous 
attendant  had  not  found  an}"^  cause  to  account  for  the 
paralysis,  a  rapid  recovery  took  place,  the  boy  being 
able  to  walk  even  before  the  complete  cicatrization  of 
the  wound,  and  was  soon  the  picture  of  health." 


260  History  of  Circumcision. 

Dr.  T.  P.  Leech,  of  Attica,  Fountain  County,  Ind., 
reports  a  case  of  a  fourteen-montb-old  cliild,  who  liad 
been  the  terror  of  all  that  part  of  the  town  for  over  six 
months,  as  he  cried  constantly.  Except  when  asleep  or 
nursed  by  his  mother,  he  would  lie  perfectly  still  and 
squall,  not  showing  any  disposition  to  sit  up  ;  nor  did  he 
like  to  be  raised  up.  He  was  very  nervous,  and  would 
have  times  when  his  limbs  would  be  rigid.  This  state 
of  things  grew  worse,  until  the  child  was  accidentally 
seen  by  Dr.  Leech,  who,  on  examination,  found  a  con- 
tracted and  adherent  prepuce,  the  child  being  at  the 
time  in  a  high  fever  and  suffering  great  nervous  excite- 
ment. An  operation  by  slitting  and  breaking  up  the 
adiiesion  afl'orded  immediate  relief;  the  spinal  irritation, 
partial  paralysis  of  the  lower  extremities,  spasms  during 
urination,  and  all  trouble  disappeared  as  if  by  magic. 

Prof,  J,  H.  Pooley,  of  Columbus,  Oliio,  reported 
the  case  of  a  fine,  healthy  boy  who,  up  to  three  months 
before  being  seen  professionally,  had  always  been  well  and 
in  perfect  liealth.  His  condition  was  found  bj^  Professor 
Pooley  to  be  one  of  localized  chorea,  manifesting  itself 
in  constant  convulsive  movements  of  the  head.  Tliey 
were  nodding  or  antero-posterior  'movements,  alter- 
nating with  lateral  or  shaking  and  twisting  motions; 
these  movements  had  become  almost  constant  during 
the  waking  hours  of  the  child.  There  was  no  distortion 
of  the  features  nor  any  choreic  movements  of  the  ex- 
tremities;  indeed,  the  whole  affection  consisted  in  the 
nodding  and  shaking  movements  of  the  head  referred  to. 
These  were  almost  incessant,  sometimes  slow  and  almost 
rhythmical,  then  for  a  minute  or  two  rapid  and  irregular, 
seeming  to  fatigue  the  little  fellow,  and  accompanied  b^'^ 
a  fretful,  whimpering  cr3^  The  child  had  been  subjected 
to   a  variety  of  treatment,  but  without  any  benefit  or 


Reflex  Neuroses  and  the  Prepuce.  261 

effect  of  any  kind.  Upon  the  most  careful  examination 
of  the  patient  and  his  history,  Professor  Pooley  could 
not  discover  anything  that  seemed  to  throw  any  light 
upon  the  case,  except  a  condition  of  well-marked  phi- 
mosis. Acting  upon  this,  the  Professor  immediately 
circumcised  the  child,  and  from  the  very  day  of  the 
operation  the  spasmodic  action  began  to  diminish,  and 
in  two  weeks  he  was  entirely  well,  without  any  other 
treatment  of  any  kind. 

Dr.  W.  R.  McMahon,  of  Huntington,  Indiana,  has 
reported  three  cases  of  epilepsy  in  children  caused  by 
congenital  phimosis  that  were  entirely  relieved  by  an 
operation  without  anj'^  subsequent  return  of  the  diffi- 
culty. One  of  the  cases  was  in  a  boy  ten  years  old,  with 
very  firm  preputial  adhesions  and  a  high  grade  of 
inflammation  of  the  parts. 

Dr.  J.  D.  Griffith,  of  Kansas  City,  Mo.,  operated  on  a 
case  of  phimosis  on  a  child  nearly  three  years  of  age,  who 
was  afflicted  with  repeated  attacks  of  convulsions  and 
paralysis  of  the  hips  and  lower  extremities  ;  the  little 
fellow  had  as  many  as  fifteen  convulsions  in  a  day ;  the 
patient  was  greatl}'  troubled  with  painful  urination  and 
priapism.  On  examination  at  the  operation,  a  firmly 
adherent  prepuoe  and  a  large  roll  of  caseous  matter  was 
found  just  back  of  the  corona.  A  complete  recovery 
followed  the  removal  of  these  conditions. 

The  above  cases  are  taken  from  the  paper  read 
before  the  Section  of  Diseases  of  Children  at  the  Inter- 
national Medical  Congress  of  1887,  b}'  Dr.  Sayre.  It 
contains  a  number  of  additional  cases  of  an  analogous 
character  to  the  above,  reported  to  him  by  physicians 
in  different  parts  of  the  country.  They  show  the  variety, 
extent,  and  far-reaching  character  of  the  diseases  in- 
duced by  any  preputial  irritation.     Dr.  G.  L,  Magruder, 


262  History  of  Circumcision. 

of  Washington,  D.  C,  in  the  same  papei*,  has  a  record 
of  twenty-five  cases  of  various  nervous  disturbances 
which  he  had  entirely  relieved  by  circumcision  or 
dilatation,  without  any  medication  whatever.  Dr. 
Magruder,  in  concluding  his  report,  in  which  he  quotes 
the  authority  of  Brown-Sequard,  Charcot,  and  Leyden, 
as  having  noticed  serious  nervous  disturbances  result- 
ing from  reflex  irritation  due  to  affections  of  the  genito- 
urinary organs,  observes  as  follows  : — 

"  From  the  foregoing,  I  think  that  we  are  justified  in 
the  conclusion  that  phimosis  and  adherent  prepuce  give 
rise  to  varied  troubles  of  more  or  less  gravity,  manifest- 
ing themselves  either  in  the  muscular,  osseous,  or  ner- 
vous systems ;  and  that  the  removal  of  these  abnormal 
conditions  of  the  penis  frequently  affords  marked  relief, 
and,  at  times,  perfect  and  permanent  cure." 

In  the  discussion  that  followed  the  reading  of  Dr. 
Saj-re's  paper.  Dr.  De  Forest  Willard,  of  Philadelphia, 
remarked  that  he  had  operated  by  simply  stripping 
back  the  prepuce  and  that  he  did  not  circumcise,  but 
that  he  looked  upon  the  subsequent  cleanliness  of  the 
parts  as  the  greatest  safeguard,  not  only  as  against 
reflex  irritation,  but  also  against  masturbation.  Re- 
tained filth  and  smegma  are  far  more  likely  to  call  a 
boy's  attention  to  his  penis  by  their  unrecognized  irri- 
tative effects  than  washing  can  possibly  do.  His  prac- 
tice is  in  accordance  with  the  belief  that  young  children 
can  be  relieved  by  the  simpler  methods,  such  as  dilata- 
tion ;  but  he  also  observes  that  when  a  child  has  reached 
eight  or  ten  years  of  age,  and  has  never  been  able  to 
expose  the  glans,  contraction  is  almost  certain  to  be 
present,  and  circumcision  must  be  performed.  In  adults 
there  is  rarely  any  escape  when  the  prepuce  is  tight. 

Dr.  I.  N.  Love,  of  St.  Louis,  said  :  "  It  has  been  my 


Reflex  Neuroses  and  the  Prepuce.  263 

judgment  and  my  practice  for  maj'  years,  in  these  reflex 
irritations,  to  pursue  tlie  radical  course  of  circumcision. 
I  believe  tlioroughly  in  tlie  Mosaic  law,  not  only  from  a 
moral  but  also  from  a  sanitary  stand-point.  All  genital 
irritation  should  be  thoroughly'  removed.  It  is  all  very 
well  to  instruct  the  mother  or  the  nurse  to  keep  the 
parts  within  tlie  prepuce  clean,  but  they  can  not  or  will 
not  do  it.  Complete  and  proper  removal  of  the  covering 
to  the  glans  takes  away  all  the  cause  of  disturbance. 
Dr.  Sayre  takes  a  more  pronounced  position  on  this 
subject  than  the  majority  of  those  who  have  discussed 
his  paper.  An  improper  performance  of  a  surgical  pro- 
cedure is  no  argument  against  the  operation,  but  rather 
against  the  operator.  For  the  reasons  I  have  given,  I 
am  in  favor  of  the  radical  application  of  the  Mosaic  rite 
of  circumcision." 

Dr.  J.  Lewis  Smith,  the  president  of  the  Section, 
believed  in  the  evil  results  of  the  reflex  irritation  due  to 
abnormality  of  the  prepuce.  In  many  instances  the 
causative  relation  of  the  preputial  disease  to  the  S3-mp- 
toms  which  it  produces  is  not  so  apparent  as  it  may  be 
in  others,  but  after  correct  treatment  of  the  prepuce 
they  disappear.  There  was  one  result  of  phimosis 
which,  he  observed,  neither  Professor  Sayre  nor  those 
who  contributed  to  his  paper  noticed.  The  expulsive 
efforts  accompanj'ing  urination  sometimes  cause  pro- 
lapsus of  the  rectum,  and  frequently  produce  inguinal 
hernia.  In  a  lecture  before  the  Harveian  Society 
{British  Medical  Journal,  February  28,  1880),  Edmund 
Owen,  Surgeon  to  St.  Mary's  Hospital  and  to  the  Hos- 
pital for  Sick  Children,  says  :  "  Perhaps  the  commonest 
cause  of  hernia  in  childhood  is  a  small  preputial  or 
urethral  orifice,  and  next  to  that  I  would  put  the 
smegma-hiding  or  adherent  prepuce."     Arthur   Kemp 


264  History  of  Circumcision. 

(London  Lancet,  July  27,  18T8),  Senior  House-Surgeon 
to  the  Children's  Hospital,  says :  "  Phimosis  is  a  com- 
mon occurrence,  and  numerous  ill  effects  can  undoubt- 
edly be  attributed  to  it ;"  and  he  alludes  to  the  obser- 
vation of  Mr.  Bryant,  as  published  in  his  book  on  the 
"  Surgical  Diseases  of  Children  ":  "  In  tift}^  consecutive 
cases  of  congenital  phimosis,  thirtj^-one  had  hernia,  five 
had  double  inguinal  hernia,  and  many  had  umbilical 
hernia  besides.  In  no  one  was  the  hernia  congenital, 
its  earliest  occurrence  being  at  three  weeks.  Circum- 
cision was  performed  in  these  cases,  and  all  were  much 
benefited."  i»3 

During  the  session  of  the  Ninth  International  Con- 
gress, where  the  above  paper  was  read  and  remarks 
made,  which  appear  in  the  third  volume  of  its  "  Trans- 
actions," another  paper  was  also  presented  by  Dr.  Saint- 
Germain,  of  Paris.  The  Doctor  fully  recognized  the 
dangers  from  a  narrow  or  adherent  prepuce,  but  did  not 
think  tha*  more  than  one  case  in  three  hundred  really 
required  circumcision  ;  he  believed  in  dilatation,  as  em- 
ployed by  Nelaton,  with  the  exception  that,  whereas 
Nelaton  employs  three  branches  to  his  dilator,  Saint- 
Germain  preferred  only  a  two-branch  dilator. 

Dr.  Lewis,  the  president  of  the  Section,  related  a 
number  of  cases  where  the  use  of  uncleanly  instruments 
had  resulted  disastrously.  But,  for  that  matter,  the 
same  objection  can  be  offered  against  dilatation,  as  a 
filthy  instrument  is  as  liable  to  infect  the  patient  as  a 
knife.  There  is  no  earthl}'  excuse  why  a  knife  that  has 
been  used  on  a  case  of  diphtheritic  croup  should  be 
used  some  hours  afterward  to  circumcise  a  child.  As 
to  the  operation  of  dilatation  practiced  1\y  Dr.  Holgate, 
it  can  reall}^  be  said  to  answer  the  immediate  demands, 
but  how  far  its  utility  is  efficient  as  to  permanent  re- 


Reflex  Neuroses  and  the  Prepuce.  265 

suits  Dr.  Holgate  has  not    given    the   profession    any 
information. 1*** 

One  of  the  most  interesting  and  instructive  papers 
that  it  was  ever  the  fortune  of  the  writer  to  listen  to, 
touching  on  the  subject  of  reflex  nervous  diseases  or 
neuroses  due  to  preputial  adhesions,  was  one  prepared 
by  Dr.  M.  F.  Price,  of  Colton,  California,  and  read 
at  the  semi-annual  meeting  of  the  Southern  California 
Medical  Societ3^,  at  its  Pasadena  meeting  in  December, 
1889.  In  the  course  of  the  paper  he  gives  a  considerable 
number  of  examples,  of  which  some  extracts  are  here- 
with given  :  One  case  was  a  boy  aged  seven,  who  for  two 
years  had  had  frequent  attacks  of  palpitation  of  the 
heart ;  when  seen  by  Dr.  Price  the  little  heart  was  labor- 
ing hard,  beating  at  a  furious  rate  (far  bej^ond  counting), 
with  a  loud  blowing  or  splashing  sound,  and  the  pulse 
at  the  wrist  a  mere  flutter.  The  breath  was  inspired  in 
a  series  of  jerks,  the  face  flushed  and  somewhat  swollen. 
The  chest-wall  was  visibly  moved  at  every  thump  of 
the  heart.  The  doctor  attended  the  child  for  a  month 
without  the  little  patient  making  any  appreciable  im- 
provement. Some  time  during  this  period  of  observa- 
tion the  father  happened  to  mention  that  the  boy  some- 
times complained  of  his  penis  hurting  him  at  the  time 
of  an  erection.  This  led  the  doctor  to  examine  the 
parts,  when  he  found  a  long  prepuce,  with  a  mucous 
membrane  adherent  to  the  glans,  about  a  line  beyond 
the  corona,  the  whole  circumference  of  the  organ.  With 
the  use  of  cocaine  and  a  blunt  instrument  the  adhesions 
were  removed,  with  an  immediate  amelioration  of  all  the 
reflex  symptoms.  The  veiy  next  paroxj-sm  was  lighter 
and  less  exhausting  ;  the  improvement  was  continuous. 
The  child  soon  went  to  school  and  had  no  further 
trouble;   but,  in  the  doctor's  opinion,  the  two  years' 


266  History  of  Circumcision. 

bard  struggle  have  not  been  without  its  evil  results  on 
the  constitution  and  organism  of  the  child. 

The  next  case  was  born  November  2,  1888  ;  a  large, 
healthy  boy  at  birth.  By  June  of  the  following  year 
the.  child  was  afflicted  with  what  the  mother  called 
"jerky  spells;"  up  to  this  time  the  boy  seemed  list- 
less, did  not  care  to  sit  up,  and  seemed  from  some  cause 
to  be  in  more  or  less  pain,  with  his  ej'es  turned  to  tiie 
left.  The  parents  dreaded  that  the  child,  their  only 
one,  would  turn  out  idiotic.  The  spasmodic  spells  al- 
luded to  were  of  a  tetanic  nature,  the  body  being  thrown 
backward ;  his  head  and  eyes  continued  to  be  turned 
to  the  left,  and  nothing  could  attract  the  child's  atten- 
tion. The  boy  cried  night  and  day,  but  he  was  in  good 
flesh,  had  all  the  teeth  he  should  have,  bowels  were  regu- 
lar, and  the  appetite  good.  Whatever  the  doctor  did  in 
the  medical  way  seemed  to  be  of  no  avail.  One  day, 
however,  he  thought  of  examining  the  prepuce,  think- 
ing, perhaps,  that  it  might  be  contracted  and  that  the 
convulsive  movements  might  be  reflexes  from  the  parts. 
On  examination  the  prepuce  was  found  elongated  and 
distended,  with  a  very  minute  opening ;  this  was  dilated 
with  difficult}',  when  the  inner  fold  was  found  adhering 
almost  the  whole  extent  of  the  glans  ;  the  dilatation 
and  breaking  down  of  these  adhesions  was  slowly  per- 
severed in,  until  sufficient  dilatation  was  obtained  and 
the  glans  was  freed.  From  the  very  first  operation  the 
convulsions  commenced  to  diminish,  both  in  force  and 
frequency',  and  a  constant  and  rapid  improvement  of  the 
child  took  place.  Six  months  afterward  the  boy  was 
perfectly  normal,  stood  by  himself,  played  with  play- 
things, and  was  an  interested  member  of  the  fainilj- 
circle. 

Case  No.  3  was  a  repetition  of  Case  No.  2,  except 


Be/lex  Neuroses  and  the  Prepuce.  267 

that,  with  the  experience  of  the  latter  case,  the  doctor 
wasted  no  time  with  medication,  but  pi'oceeded  at  once 
to  examine  the  prepuce,  which  was  found  to  be  very 
long,  and  with  a  pin-hole  opening.  The  dilatation  of 
this  and  the  breaking  up  of  the  adhesions  gave  imme- 
diate relief.  During  the  course  of  the  paper  lie  quoted 
the  case  related  by  13 rown-Sequard,  and  recorded  in  tiie 
New  York  Medical  Record,  vol.  xxxiv,  p.  314,  where  he 
"  related  a  very  interesting  case  that  presented  all  the 
rational  signs  of  advanced  cerebral  disease,  a  case  tliat 
he  considered  quite  hopeless,  that  was  relieved  by  an 
operation  for  phimosis  and  the  treatment  of  an  inflam- 
matory condition  of  the  glans  penis."  To  use  Brown- 
Sequard's  own  words,  "So  rapid  was  the  recover}^  that 
within  six  weeks  from  the  da}^  of  the  operation  he  pre- 
sented himself  at  my  office  perfectly  well  in  every 
respect." 

In  the  early  part  of  this  book,  in  speaking  of  female 
circumcision,  it  was  mentioned  that  when  the  medical 
part  of  the  volume  should  be  reached  some  medical 
reasons  for  its  necessity  would  be  given.  Dr.  Price,  in 
his  paper,  gives  some  information  on  this  subject, which 
is  of  the  greatest  interest.  In  the  course  of  the  paper 
he  says  as  follows  :  "  Nor  do  I  think  these  reflex  neu- 
roses from  adherent  prepuce  wholl3'  confined  to  the  male 
sex.  The  preputium-clitoridis  may  be  adherent  and 
produce  in  the  female  similar  reflexes.  During  the  ses- 
sion of  the  American  Medical  Association,  held  in 
Chicago  in  1874,  I  think,  I  ttended  one  afternoon  a 
clinical  lecture  by  Dr.  Sayre.  A  little  girl,  fourteen 
3'ears  of  age,  but  about  the  size  of  a  seven-year-old 
child,  was  brought  in,  who  had  never  walked  nor  spoken, 
but  with  quite  an  intelligent  countenance,  who  was  in 
constant  motion,  and  who  presented  very  manj-  nervous 


268  History  of  Circumcision. 

symptoms.  Dr.  Sayre  examined  her,  and  found  the 
prepuce  adherent  the  whole  extent  of  the  clitoris.  He 
gave  it  as  his  opinion  that  here  was  the  primary  and 
sole  cause  of  the  sjanptoms,  and  that  appropriate  treat- 
ment shortly  after  birth  would  have  prevented  all  the 
serious  consequences  so  painfully  apparent,  and  which 
was  then  too  late  to  remedy. 

"  I  once  had  occasion  to  pass  a  catheter  into  the 
bladder  of  a  lady  who  presented  an  innumerable  train 
of  nervous  symptoms,  often  bordering  on  insanity,  but 
was  unable  to  do  so  without  exposing  the  parts.  Al- 
though the  meatus  could  be  distinctly  felt,  the  catheter 
would  not  enter.  On  exposure  to  view,  an  opening  was 
seen  in  the  clitoris,  which  was  firml3-  bound  down  by 
preputial  adhesions  near  the  extremity  of  the  organ. 
Entering  the  catheter  at  this  point,  it  readily  passed 
through  the  clitoris,  then  down  through  a  passage 
under  the  mucous  membrane  to  the  natural  site  of 
the  meatus,  on  into  the  urethra,  and  through  into  the 
bladder.  In  the  light  of  recent  experience,  my  opinion 
now  is,  that  here  was  the  cause  of  all  the  nervous  symp- 
toms in  this  case." 

The  relative  disposition  in  regard  to  the  irritability 
of  the  external  sexual  organs  as  existing  in  the  female, 
when  contrasted  with  the  male,  is,  for  some  reason,  not 
sufficiently  considered  or  understood.  The  idea  of 
masturbation  or  of  irritation  from  the  genitals  ending  in 
reflex  neuroses  is  alwa3's,  as  a  rule,  associated  with  the 
male,  and  that  it  has  not  been  more  associated  with  the 
female  has  deprived  her  of  the  same  benefit  that  the  pros- 
ecution of  the  stud}'  in  this  regard  has  been  to  the  male 
sex.  Masturbation  among  the  feeble-minded,  which  is 
so  common,  must,  of  necessit}^  have  for  its  determining 
cause  a  foundation  of  morbid  irritability  of  the  sexual 


Reflex  Neuroses  and  the  Prepuce.  269 

organs.  This  is  well  known  to  be  so  among  the  males, 
whose  hands  seem  instinctively  to  be  drawn  to  those 
parts.  Dr.  C.  F.  Taj^lor,  of  New  York,  in  an  article  on 
the  "Effect  of  Imperfect  Hygiene  of  the  Sexual  Func- 
tion," published  in  the  American  Journal  of  Obstetrics  for 
Januarj^  1882,  gives  us  an  account  of  his  investigations 
in  tliis  regard,  with  the  following  results  :  "  In  an  asylum 
for  the  feeble-minded  of  both  sexes,  it  was  found  that  the 
habit  was  about  equal  in  the  two  sexes,  there  being  only 
this  difference  :  that  the  females  began  to  masturbate 
one  or  two  jears  earlier  than  the  males,  and  that  the 
habit,  once  established,  was  found  to  be  more  persistent 
than  in  the  males.  It  was,  further,  ascertained  that  the 
habit  came  naturally',  without  the  aid  of  precept  or 
example  to  either  sex." 

It  may  well  be  a  question  as  to  whether  the  feeble- 
mindedness be  not  a  reflex  condition  from  this  exces- 
sive morbid  irritability  of  the  sexual  organs.  There  is 
not  much  doubt  but  that,  if  one  of  the  cases  reported 
by  Dr.  Price  had  not  been  circumcised,  the  expres- 
sionless, listless  infant  would  have  grown,  in  time,  into 
a  masturbating,  feeble-minded,  idiotic  creature,  as  many 
others,  so  situated,  have  done  before  it.  Now,  would  it 
have  been  logical  to  have  laid  the  morbid  irritability  of 
its  generative  organs  to  its  feeble-mindedness,  when  its 
feeble-mindedness  was  full}'  demonstrated  to  have  been 
wholl}'  dependent  on  the  sexual  irritation  ?  From  these 
premises  we  might  take  another  step  forward,  and  ask 
whether,  under  a  proper  hygienic  prophylaxis, — which 
would  in,volve  a  thorough  inspection  of  the  genitals 
of  all  children  reported  to  be  either  ph3'sically  or 
mentally  deficient,— such  a  course  would  not  greatly 
diminisli  the  number  of  paralytics,  feeble-minded,  and 
generally   deficient   of  both   sexes  ?     If  the   results  in 


2t0  History  of  Circumcision, 

private  practice  are  any  criterion,  it  is  safe  to  assert 
tliat  a  strict  adherence  to  the  Mosaic  law  for  the  males 
and  to  some  of  the  African  customs  for  the  females 
would  most  assuredly  relieve  all  these  cases  that  might 
come  under  the  caj)tion  of  results  of  reflex  neuroses. 
Twenty  years  ago  this  subject  was,  to  the  bod^'  of  the 
profession,  a  terra  incognita  in  regard  to  the  male,  and, 
as  the  female  is  similarly  subject  to  the  same  morbid 
influence,  it  is  to  be  hoped  that  in  the  present  decade 
she  will  receive  the  same  attention  which  the  profession 
is  now  beginning  to  pay  to  the  male  sex."^ 

In  the  foregoing  parts  of  this  chapter,  examples  of 
reflex  neuroses  have  been  given  to  show  the  ditferent 
effects  that  genital  irritation  will  produce.  The  cases 
given  were  chosen  for  the  diversity  of  variety  of  s^nnp- 
toms,  and  as  cases  representing  the  aflfectio'n,  without 
any  other  complication.  Many  more  could  have  been 
added,  but  they  are  unnecessar}'.  In  the  writer's  prac- 
tice there  has  been  a  number  of  cases  in  the  adult  that 
have  exemplified  that  this  form  of  ailment  is  by  no 
means  restricted  to  children,  as  has  been  shown  in  the 
case  reported  b}'^  Dr.  Mott  to  Dr.  Sayre,  in  regard  to  the 
middle-aged  man  with  a  string  about  his  penis.  One  of 
these  cases  was  that  of  a  young  man,  six  feet  in  stature, 
broad-shouldered,  and  well  built.  He  applied  for  relief 
for  a  d3'^spepsia  that  affected  his  stomach  and  also  his 
heart.  The  man  had  an  apparentl}^  feeble  and  irri- 
table heart;  cold, clammy  skin  ;  disturbed  digestion, and 
uneasy  sleep ;  was  constipated  and  flatulent.  No  treat- 
ment seemed  to  make  any  impression  upon  his  case. 
At  last  he  began  to  emaciate  and  look  haggard.  His 
mind  was  also  becoming  visiblj'  weaker,  was  attacked 
by  dizziness,  and  on  several  occasions  he  fell  in  a  fit. 
With  this  condition  he  at  last  began  to  have  frequent 


Rejiex  Neuroses  and  the  Prepuce.  271 

nootui'nal  emissions.  On  account  of  the  latter  his  gen- 
ital organs  were  examined,  and  the  penis  was  found 
smaller  than  the  average,  with  a  long  and  narrow  pre- 
puce. The  glans  could  easily  he  uncovered,  but  the 
tightness  of  the  prepuce  and  its  unyielding  qualities . 
made  paraphimosis  a  possibility ;  so  that  the  young  man, 
having  once  or  twice  had  considerable  difficulty  in  re- 
turning the  prepuce  to  its  place,  never  attempted  its 
retraction  again.  There  were  no  adhesions,  but  the 
inner  fold  of  the  prepuce  had  been  thickened  by  bala- 
nitis. Seeing  the  need  of  circumcision  for  the  local 
benefit,  the  operation  was  suggested  with  a  view  of 
relieving  the  pressure  on  the  glans,  which  was  looked 
upon  as  the  probable  cause,  in  his  broken-down .  con- 
dition, of  the  advent  of  the  nocturnal  emissions.  He 
gladly  submitted,  and,  to  the  surprise  of  both  physician 
and  patient,  all  his  troubles  disappeared,  and  he  at  once 
became  a  changed  man.  So  impressed  was  he  with  the 
result,  that,  on  his  return  to  his  home,  he  examined  his 
younger  brother,  and,  finding  him  with  a  like  long, 
narrow  prepuce,  he  immediately  brought  him  in  and  had 
him  circumcised,  as  a  prophj'lactic  against  his  being 
subjected  to  the  risk  of  lost  health  as  he  himself  had 
suffered. 

Another  case,  a  man  of  forty -five,  also  a  farmer,  was 
afflicted  with  d3'spepsia,  palpitation  of  the  heart,  general 
debilit}',  constipation,  constant  headache,  etc.  He  could 
not  cut  up  an  armful  of  wood  without  bringing  on  palpita- 
tions and  gaseous  eructations,  or  being  upset  for  tlie  day  ; 
and  after  having  connection  with  his  wife  he  generally 
had  a  terrific  headache,  lasting  for  two  or  three  days;^"® 
he  could  stand  no  protracted  mental  effort,  even  such  as 
is. required  to  make  an  addition  of  a  long  line  of  figures, 
or  the  least  business  worry,  without  the  supervening 


2*72  History  of  Circumcision. 

headnehe.  All  treatment  against  these  conditions  was 
useless  ;  the  colon  was  kept  empty,  the  diet  was  changed ; 
.pepsin  and  bismuth,  tonics,  frictions,  Turkish  baths, 
and  all  hygienic  observances  and  moral  treatment  were 
all  of  no  avail.  One  day,  on  consulting  the  writer,  he 
complained  of  a  pruritus  at  the  head  of  the  penis.  On 
examination  it  was  found  that  he  had  a  narrow,  long 
prepuce,  a  congenitally-contracted  meatus,  and  was  then 
stitfering  with  a  slight  balanitis.  He  was  very  careful 
to  keep  the  parts  clean,  but,  he  informed  me,  that  in  spite 
of  all  precautions,  these  attacks  would  come  on.  The 
mucous  covering  of  the  inner  fold  of  the  prepuce  and 
glans  was  so  irritable  that  connection  often  brought  it 
about.  The  glans  was  small  and  elongated,  with  the 
meatus  red,  and  with  lips  cedematous  and  congested.  To 
free  him  from  this  tormenter,  circumcision  was  advised. 
The  part3'  could  not,  however,  remain  away  from  home 
for  the  time  required  for  the  operation  ;  so  that  a  com- 
promise operation  was  performed, — one  that  would  not 
keep  him  from  business,  and,  at  the  same  time,  relieve 
the  contracting  pressure  on  the  glans.  This  was  by 
Clouquet's  operation  and  bandaging  back  the  prepuce 
over  the  penis,  back  of  the  corona, — an  operation  that,  in 
my  hands,  has  often  filled  all  the  desired  purpose.  The 
meatus  was  also  incised.  After  the  operation  all  of  his 
troubles  disappeared,  as  tliey  had  done  in  the  preceding 
case,  and  he  was  soon  a  hearty  and  well  man,  able  to  chop 
wood,  attend  to  business,  and,  in  case  of  need,  do  family 
duty  for  a  Turkish  harem  without  recurrence  of  his  old. 
tormenting,  dj'speptic  palpitation  or  sick-headache. 

The  writer  has  resorted*  to  circumcision  in  many 
cases  to  improve  the  temper  and  disposition  of  children, 
with  the  best  of  results,  and  in  one  case,  in  association 
with  another  physician,  performed  tlie  operation  on  a 


Reflex  Neuroi^es  and  the  Prepuce.  2Y3 

lunatic,  whose  lunacy  ran  to  women  and  girls,  with 
whom  he  would  fall  desperately  in  love,  without  any 
encouragement  or  provocation,  or  even  acquaintance ; 
finally  reaching  spells  of  such  incoherence  of  action 
and  speech  that  confinement  would  be  required.  The 
peculiarity  of  his  hallucinations  called  attention  to  the 
genital  organs.  This  man  had  never  masturbated,  and 
was,  when  well,  a  compactly-built,  active,  and  intelligent 
man.  By  occupation  he  was  a  contractor,  and  a  man 
of  more  than  usual  executive  ability  besides.  On 
examination  it  was  found  that  he  was  a  subject  of  con- 
genital phimosis,  never  having  been  able  to  uncover  the 
glans.  He  had  been  in  the  habit  of  washing  out  the 
preputial  cavity  by  the  aid  of  a  flat-nozzled  syringe. 
The  prepuce  was  long,  but  not  thick ;  nevertheless,  it  was 
inelastic  and  very  firm.  The  examination  seemed  to 
have  a  good  mental  effect  upon  the  man,  as  it  made  him 
quite  rational  for  the  moment.  He  entered  into  the 
idea  that  this  condition  had  some  connection  with  his 
derangement  very  intelligently,  even  suggesting  many 
sj'mptoms  and  attacks  that  he  had  suffered  from  child- 
hood up  as  probably  gradual-stepping  processes  through 
which  his  present  condition  had  been  reached.  He 
cheerfully  submitted  to  a  thorough  circumcision,  which 
had  the  effect  of  ameliorating  his  condition.  He  was 
subsequently  sent  to  an  asylum,  where,  after  a  short 
time,  he  was  discharged  well.  Some  years  afterward, 
conscious  of  feeling  a  return  of  the  mental  derange- 
ment, he  voluntarily  applied  for  admission  to  the  same 
institution  and  remained  until  better. 

This  case  is  \Qxy  instructive.  The  patient  readily 
connected  his  mental  trouble,  by  a  retrospective  view 
through  a  series  of  gradually -increasing  troubles,  that 
originated  in  the  preputial  condition,  to  the  phimosed 


274  History  of  Circumcision. 

condition  of  that  appendage,  and  he  was  certain  that  this 
prepuce  had  been  at  the  bottom  of  all  the  ph3'sical  and 
mental  trouble  he  had  experienced.  The  reflex  nervous 
train  of  affections  had  undoubtedly  produced  some  local- 
ized lesion  in  the  brain-structure.  The  natural  sound, 
healthy  organism  of  that  organ,  and  the  bright,  active 
nature  of  his  mind,  however,  prevented  a  total  wreck- 
age of  the  mental  faculties.  It  is  safe  to  assume  that, 
had  he  had  the  ordinary  listless,  unresisting  mind,  dis- 
posed to  brood,  and  easily  cast  down,  he  would,  from 
the  first  derangement,  have  become  a  hopeless  and 
demented  lunatic.  The  circumcision  could  not  undo  all 
the  mischief  that  had  been  accomplished,  some  of  which 
had  certainly  left  a  permanent  taint,  but  the  mildness 
of  his  future  attacks  and  the  better  exercise  of  his 
volition  were  the  undoubted  results  of  the  operation. 


CHAPTER  XXIY. 

Dysuria,  Enuresis,  and  Retention  of  Urine. 

Any  dissertation  on  circumcision  and  its  man}'  uses, 
eitlier  prophylactic  or  curative,,  would  be  incomplete 
without  a  reference  to  enuresis ;  another  reason  for 
making  a  somewhat  full  reference  to  the  subject  would 
be  the  undecided  position  that  this  morbid  condition 
seems  to  occupy  in  medical  literature,  as  well  as  the 
meagre  and  unsatisfactor3'  treatment  it  has  received  by 
the  majority  of  those  who  have  mentioned  it.  It  is 
anomalous,  to  say  the  least,  to  find,  in  general  or  special 
literature,  enuresis  mentioned  as  a  diseased  condition 
peculiar  from  bab3'hood  to  pubert}' ;  to  find  it  fully 
described  and  to  have  it  stated  that  it  is  a  wideh-preva- 
lent  distemper,  aflfecting  both  sexes  alike  ;  to  know  that 
it  is  an  anno3'ing,  intractable,  persistent  condition, 
wearing  to  the  child  in  everj^  sense,  subjecting  it  to  a 
demoralizing  mortification  as  well  as  to  unmerited  scold- 
ings, humiliations,  and  punishments,  and  that  its  habit,  in 
badly-ventilated  quarters,  will  breed  other  diseases,^''^as 
well  as  that  its  continued  action  tends  to  the  development 
of  onanism,  with  its  long  and  widel3'-ramifying  trains 
of  physical  and  social  ills;  and  to  find  works  especially 
devoted  to  children's  diseases  silent  on  the  subject. 
Knowing  all  these  things,  and  also  that  Ultzmann,  Lalle- 
mand,  and  others  who  have  treated  this  affection,  men- 
tion it  as  a  children's  disease, it  is  unaccountable  to  reason 
out  why  most  of  our  text-books  and  treatises  on  chil- 
dren's diseases  should  be  so  remarkably  and  unreasonably 
silent.     It   certainly  cannot   be   laid   to  its  lacking  in 

(275) 


276  History  of  Circumcision. 

study  matex'ial,  as  the  author  of"  Quain's  Dictionary  of 
Medicine "  saj^s  :  "  It  is  one  relative  to  which  much 
might  be  written  without  exhausting  the  subject,  the 
patliology  of  which  has  wide  and  manifold  relations. 
.  .  .  There  appears  to  be  something  analogous  be- 
tween this  condition  and  that  which  determines  in 
after  life  the  seminal  emissions  under  similar  circum- 
stances," Our  American  works  are  notably  deficient  in 
this  regard  ;  although  Stewart,  of  Xew  York,  in  his 
"Diseases  of  Children,"  published  over  fifty  years  ago, 
devotes  a  chapter  to  dysuria  and  one  to  retention  of 
urine,  treating  the  subject  quite  full}^,  even  down  to  the 
description  of  preputial  calculi ;  he,  however,  failed  to 
notice  that  the  irritation  of  preputial  constriction  or 
a;dhesions  will  produce  both  conditions,  and,  following 
many  of  the  authors  of  the  time,  as  has  been  done 
since,  he  adopted  the  urino-digestion  theory  of  acid  and 
irritating  urine,  due  to  faultj^  digestion,  of  Prout  and 
Magendie,  who  looked  to  regulating  the  digestion  of  the 
child,  or  the  mother  who  nursed  it,  as  the  onl}'  method 
of  cure;  the  lithic-acid  diathesis  being,  in  their  opinion, 
the  main  thing  to  be  guarded  from. 

Other  works  that  mention  these  conditions  are 
equally  on  the  wide  sea  of  speculation,  as  the}^  all,  more 
or  less,  look  upon  the  treatment  that  the}'  advise  as  in- 
definite and  unsatisfactory,  showing  an  equal  want  of 
•sound  anchorage-grounds  for  their  etiological  reason- 
ings. Dillnberger,  of  Vienna,  in  his  hand-book  of  chil- 
dren's diseases,  mentions  enuresis,  but  has  nothing  better 
to  offer  for  its  relief  than  that  advised  by  Bednar,  wlio 
followed  a  systematically^ -timed  period  of  awakening, 
gradually  lengthened  out,  from  the  time  of  putting  the 
child  to  bed.  In  addition,  he  advises  internal  medica- 
tion,  and,  like  TJltzmann,  he  recoguizes  the  possibility 


Dysuria,  Enuresis,  and  Retention  of  Urine.      217 

of  a  local  cause  in  little  girls,  in  whom  he  advises  the 
local  application  of  nitrate  of  silver.  Edward  Ellis 
mentions  dj'suria,  and  a  long  prepuce  is  noticed  among 
its  numerous  causes.  The  works  that  give  the  subject 
the  most  intelligent  treatment  (the  word  "intelligent"  is 
here  used  advisedl}^,  and  is  in  reference  to  the  results 
obtained)  are  those  of  West,  of  London,  and  Henoch, 
of  Berlin.  .West,  in  his  "Diseases  of  Children,"  sa3''s  : 
"  In  the  child,  however,  we  sometimes  find  the  symp- 
toms produced  by  difficult}^  in  making  water  owing  to 
the  length  of  the  prepuce  and  the  extreme  narrowness 
of  its  orifice,  which  may  even  be  scarcely  large  enough 
to  admit  the  head  of  a  pin.  This  congenital  phimosis 
is,  I  may  add,  not  an  infrequent  occasion  of  incontinence 
of  urine  in  children,  and  is  also  an  exciting  cause  of  the 
habit  of  masturbation,  owing  to  the  discomfort  and 
irritation  which  it  constantly  keeps  up.  In  every  case, 
therefore,  where  any  difficulty  attends  the  passing  or  the 
retention  of  the  urine,  or  where  the  practice  of  mastur- 
bation is  suspected,  the  penis  ought  to  be  examined, 
and  circumcision  performed  if  the  preputial  opening  is 
too  small.  This  little  operation,  too,  ought  never  to  be 
delayed,  since,  if  put  off,  adhesions  are  very  likely  to 
form  between  the  glans  and  the  foreskin,  which  render 
the  necessaiy  surgical  proceeding  less  easy  and  more 
severe." 

In  the  "  Lectures  on  Diseases  of  Children,"  Henoch, 
of  Berlin,  says  :  "  I  need  scarcely-  add  that  an  examina- 
tion of  the  external  genitals  should  never  be  omitted 
in  any  case  of  dj^suria  during  childhood.  You  will  not 
infrequently  discover  a  phimosis  which  interferes  more 
or  less  with  the  discharge  of  urine  and  retains  portions 
of  the  latter  behind  the  foreskin,  where  it  may  decom- 
pose and  give  rise  to  an  inflammatory  condition  of  the 


278  History  of  Circumcision. 

prepuce,  with  painful  dysuria.  .  .  .  This  is  also  true 
of  the  occasional  adhesion  of  the  labia  minora  in  little 
girls,  like  the  similar  adhesion  of  the  foreskin  in  boj'S. 
■It  is  almost  constant  in  the  first  period  of  life,  but  some- 
times persists  to  the  end  of  the  first  year;  can  usually 
be  torn  by  the  handle  of  the  scalpel,  and  rarely  requires 
an  incision.  In  a  few  cases  this  adhesion  appeared  to 
me  to  be  the  cause  of  .the  d3'suria,  which  disappeared 
after  the  separation  of  the  labia  from  one  another." 

Henoch,  however,  does  not  seem  to  have  grasped  the 
full  relation  that  the  natural  phimosis  of  young  chil- 
dren bears  to  dysuria,  as  he  here  follows  the  preA'ailing 
opinion,  that  where  by  dint,  push,  hauling,  and  hard 
■work  the  prepuce  can  be  pushed  back  phimosis  does 
not  exist,  as  well  as  the  general  apathy  to  the  isxct 
that  a  prepuce  can  exert  a  very  injurious  influence  by 
its  pressure,  even  when  not  adherent  and  very  retract- 
able ;  such  a  prepuce  is  often  attended  by  balanitis  and 
posthitis,  with  an  accompanying  difficult,  frequent,  and 
painful  urination.  In  a  case  wliich  will  be  related  far- 
ther on,  in  the  discussion  of  the  systemic  effects  of  a 
long,  contracted  prepuce,  as  it  induces  diseased  action 
by  continuity  of  tissues,  there  is  an  account  of  a  death 
of  a  two-year-old  child  which  we  can  assume  to  have 
had  its  original  starting-point  in  a  condition  of  phimosis. 
Henoch,  however,  rather  attributes  the  death  in  that 
case  to  what  may  well  be  considered  tlie  result  of  a 
cause,  leaving  the  original  cause  more  to  appear  as  a 
final  accessory  condition. 

M_y  reasons  for  this  view  of  the  subject  are  simply 
owing  to  the  fact  that  I  do  not  believe  that  a  child  can 
long  be  afflicted  with  the  ischuria  phimosica  of  Sauvages 
without  having  tlie  urinary  organs  beyond  more  or  less 
seriously  aflected.  from  the  mere  retention  alone,  irre- 


Dysuria^  Enuresis^  and  Retention  of  Urine.      279 

spective  of  an}^  reflex  irritation  from  tlie  pressure  on  the 
glans  or  of  any  fromtlie  irritation  of  the  peripheral  nerves ; 
the  dilatation  of  the  adjacent  cavities  or  channels  and 
the  deposit  of  calcareous  matter  being  facilitated  by  the 
retention  of  urine  and  its  naturally  altered  condition 
owing  to  tliat  retention.  So  tliat  dysuria  in  young  chil- 
dren, beginning  in  a  slightly  phimosed  condition,  or  in 
the  irritability  of  the  glans  and  meatus,  due  to  its  pre- 
putial covering,  it  is  safe  to  assume,  maj'  produce  a  train 
of  symptoms  ending  in  permanently -injured  health,  or 
even  death.  The  irritating  urine  of  a  slight  access  of 
fever  may,  by  its  passage  over  the  irritable  mucous  lining 
of  the  prepuce,  be  the  initial  starting-point  of  a  serious  or 
fatally-ending  disease.  In  all  of  these,  it  must  be  ad- 
mitted, the  presence  of  the  prepuce  is  either  actively  or 
passively  the  cause  of  the  most  serious  disease  processes 
that  may  follow. 

Ultzmann,  of  Vienna,  in  his  work  on  the  "  Neuroses 
of  the  Genito-Urinary  Organs,"  gives  the  subject  of 
enuresis  considerable  attention.  It  is  not  a  work  oiv 
diseases  of  children,  but  it,  nevertheless,  goes  into  the 
subject  as  if  it  were,  and  furnishes  the  profession  with 
considerable  information.  He  defines  enuresis  to  be 
the  passage  of  urine  of  a  normal  quality  in  a  child  who, 
with  the  exception  of  this  involuntary  urination,  is 
healthy.  In  the  first  periods  of  life,  a  slight  vesical  or 
intestinal  expulsive  effort  is  sufficient  to  overcome  the 
guarding  sphincter  muscles  at  their  outlet ;  the  child 
first  obtains  a  voluntary  control  of  the  rectal  sphincter; 
and,  generally,  with  the  second  year  it  gains  control  of 
the  vesical.  Those  who  pass  their  second  j^ear  without 
obtaining  this  control,  but  in  whom  the  organs  and  urine 
are  normal,  maj^  be  said  to  be  afflicted  with  enuresis. 
He  divides  enuresis  into  three  varieties ;  that  iuvolun- 


280  History  of  Circumcision. 

tavy  urination  which  takes  place  at  night  during  sleep 
he  terms  the  nocturnal;  that  which  takes  place  while 
climbing,  laughing,  coughing,  or  in  the  course  of  any 
violent  muscular  exercise  is  the  diurnal;  and  that 
wherein  the  involuntary  evacuation  takes  place  day  and 
night  alike  he  terms  as  the  continued.  This  last  is 
again  subdivided  into  the  continuous  and  periodical. 
As  a  cause, he  cites  anaemia,  scrofula,  rachitis;  but  adds 
that  physical  debility  is  not  necessary  for  its  presence, 
as  well-developed,  vigorous,  pufly  children  are  as  liable 
to  be  affected  as  thin  and  scrawny  ones ;  while  not  all 
scrofulous  or  rachitic  children  are  so  affected,  only  a 
small  portion  being  enuretic.  Sex  has  no  influence  on 
the  liability  that  tends  to  being  attacked,  the  proportion 
between  the  sexes  being  about  equal.  As  to  age,  he 
finds  the  greatest  proportion  to  be  between  three  and 
ten  years,  but  he  has  often  treated  those  of  either  sex 
even  at  the  age  of  fourteen  and  up  to  seventeen  years. 
It  is  absolutely  necessaiy  to  examine  the  external  geni- 
tals and  the  urine  of  those  affected  by  this  disease,  as 
phlegmasiae  of  the  vagina,  of  the  vestibule  or  uretlira 
in  girls,  or  the  practice  of  onanism,  or  lithiasis,  cystitis, 
or  pyelitis  may  be  the  cause  of  the  disease.  Girls  are 
apt  to  be  found  affected  with  polypoid  excrescences  at 
the  meatus,  which  when  removed  will  cause  the  enuresis 
to  disappear. 

From  the  above  It  will  be  observed  that  Ultzmann  has 
paid  much  attention  to  these  neuroses;  but  it  will  also 
be  remarked  that  neither  the  balanitis,  collection  of  in- 
fantile smegma,  preputial  adhesions  nor  ii'ritations  are 
taken  into  any  account  as  possible  factors  of  either 
dysuria  or  enuresis  ;  he  has  followed  more  or  less  an 
electrical  form  of  treatment  for  genito-urinarj'^  neuroses, 
the  rectal  rheophore  being  one  of  his  favorite  modes  "of 


Dysuria^  Enuresis,  and  Retention  of  Urine.      281 

treating  enuresis;  in  his  etiological  views  of  these  dis- 
turbances he  has  adhered  more  or  less  to  the  views  of 
Trousseau,  Bretonneau,  and  Dessault,  who  looked  upon 
a  debilitated  or  anomalous  condition  of  the  vesical  neck 
as  the  cause  of  the  majority  of  neuroses  in  that  region. 
It  may  be  asked  why  these  celebrated  and  observing 
physicians  have  neglected  the  preputial  condition,  if,  as 
it  is  claimed,  it  is,  in  itself,  so  important  and  sure  a 
factor  of  the  derangements  at  the  vesical  neck  ?  To 
answer  this,  or  to  explain  an}'  marked  discrepanc}'  that 
may  occur  in  medicine  between  minds  equally  as  acute 
and  febserving,  it  is  but  necessary  to  observe  that  there 
is,  in  medicine,  to  a  certain  extent,  a  like  rule  of  inherit- 
ance, education,  with  fashion  or  custom  of  habit  of 
thought  and  practice,  as  we  find  in  religion.  Canon 
Kingsley  and  Froude  are  equally  as  acute  and  discerning 
as  the  late  Cardinal  Newman,  but  that  did  not  necessi- 
tate their  following  that  prelate  into  the  foremost  ranks 
of  the  Catholic  Church ;  and  Pere  Hyacynthe  was 
equally  as  intelligent  as  Cardinal  Newman,  but  that 
did  not  prevent  him  from  leaving  the  fold  into  which  the 
Cardinal  had  entered  from  out  of  the  Reformed  Churcli. 
Some  are  born  Catholics  or  Protestants,  and  are  so  with 
vehemence ;  others  are  born  in  these  religions,  but  are 
only  lukewarm  in  their  doctrinal  observance;  while 
others  reason  and  jump  the  traces  in  either  direction. 
The  followers  of  the  destructive  theories  of  Bronssais 
could  not  see  the  errors  of  their  wa3'S,  and  neither 
could  they  be  made  to  see  the  merits  of  a  less  interfering 
form  of  medical  practice.  Trousseau  was  himself  at 
one  time  tainted  with  Bronssaisism,  but,  like  Paul  of 
Tarsus,  he  was  made  to  see  the  error  of  his  way,  as  he 
relates,  througii  a  case  of  gout  that  he  nearly  laid  out 
in  trying  to  lay  out  the  disease  antiphlogistically. 


282  History  of  Circumcision. 

I  do  not  assume  that  preputial  irritation  is  at  the 
bottom  of  all  cases  of  dysuria  or  enuresis,  any  more 
than  it  would  be  rational  to  den}^  that  cases  of  circura- 
cision  performed  in  some  cases  of  diabetic  enuresis  have 
proved  fatal  as  a  result  of  the  operative  interference; 
but  it  is  safe  to  assume  that,  in  the  great  number  of 
cases  in  whom  some  irritating  conditions  were  found 
and  removed,  the  enuresis  or  dysuria  was  due  to 
such  preputial  irritation.  It  is  also  logical  to  assume, 
with  West  and  Henoch,  that  tlie  organ  should  in  all 
cases  be  examined,  and  its  condition  rendered  as  harm- 
less as  possible.  That  the  condition  of  preputial  irri- 
tation has  not  been  fully  recognized  by  all  parties  as 
a  cause  of  enuresis  does  not  do  away  with  the  fact  that 
it  does  exist,  an^'^  more  than  tlie  refusal  of  the  prelates 
and  doctors  of  Salamanca  to  listen  to  Columbus  did 
awaj'  with  the  fact  of  the  existence  of  the  American 
continents. 

A.  L.  Ranney,  in  his  "  Lectures  on  Nervous  Dis- 
eases," pages  174,  175,  speaks  of  enuresis  in  children  as 
being  a  reflex  cachexia,  "  excessive  stimulation  of  the 
centripetal  nerves  connected  with  the  so-called  '  A'esical 
centres  '  of  the  spinal  cord," — a  condition  which  may  be 
produced  by  eitlier  worms  in  the  intestines  or  b}'  preputial 
irritation.  Ranney  advises  a  careful  exploration  of  the 
urethra  and  rectum  in  these  cases,  and  the  elimination 
of  all  local  causes  of  the  conditions. 

Probably  the  most  remarkable  case  of  the  immediate 
continuous  effects  resulting  from  phimosis  is  the  one 
recorded  by  Yidal,  in  the  fifth  volume  of  the  third 
edition  of  his  "  Surgery."  This  was  a  young  man  with 
a  congenital  phimosis,  having  but  a  \Qvy  small  aperture ; 
on  an  operation  to  relieve  the  phimosis  there  was  a 
gush  of  water,  but  this  only  fell   at   the  feet  of  the 


Dysuria,  Enuresis^  and  Retention  of  Urine.      283 

patient,  without  being  ejected  at  any  distance ;  the 
urethra  was  found  to  have  undergone  precise!}"  the  same 
dilatation  back  of  this  preputial  orifice  that  it  usually 
undergoes  back  of  a  stricture ;  the  whole  urethra  from 
the  meatus  backward  was  found  to  have  exceeded  the 
calibre  of  that  of  the  vesical  neck  ;  the  bladder  was 
greatly  dilated. 


CHAPTER  XXY. 

General  Systemic  Diseases  Induced  by  the  Prepuce. 

Aside  from  all  the  local  affections  or  reflex  neuroses, 
either  mental  or  physical,  that  a  prepuce  may  induce, 
there  are  an  innumerable  train  of  diseases  that  may 
originate  in  this  one  cause  that  at  first  sight  would 
seem  to  have  no  connecting-link  with  any  preputial 
condition. 

It  has  already  been  suggested  that  the  prepuce  does 
not  at  all  ages  bear  the  same  analogous  relation  to  man. 
In  childhood,  especially  during  our  earliest  j^ears,  it  is 
out  of  all  proportion  in  size  when  compared  to  the  rest 
of  the  organ,  or  to  any  use  it  may  have  placed  to  its 
credit.  Man  does  not,  then,  certainly  need  that  refine- 
ment of  nervous  sensitiveness  in  the  corona  that  is 
useful  in  after  life  in  inducing  the  flow  or  ejaculation  of 
the  seminal  fluid  ;  neither  is  there  at  that  age  much  of  a 
corona  to  protect.  In  middle  life,  or  what  might  be 
called  the  procreative  period  of  man,  when  the  corona 
would  seem  to  require  all  its  excitability  or  sensitive- 
ness, seems  to  be  the  very  season  in  life  when  the  glans 
is  most  apt  to  remain  uncovered  ;  so  that  nature  and 
this  h3'pothetical  idea  of  the  use  of  the  prepuce  are 
evidently  at  variance.  So  we  go  through  childhood 
with  this  long  funnel-shaped  appendage  into  manhood, 
when  the  increasing  size  of  the  body  of  the  penis  re- 
stores a  sort  of  equilibrium  between  the  size  and  bulk 
of  the  organ  and  its  integumentary  covering.  At  this 
period,  as  we  have  seen,  although  it  does  not,  from  the 
equilibrium  restored,  and  the  more  or  less  use  to  which 
(284) 


General  Systemic  Diseases  Induced  by  the  Prepuce.     285 

it  is  subjected,  induce  any  great  immediate  or  uncom- 
plicated troubles,  it  nevertlieless  endangers  the  existence 
of  the  penis  through  the  accidental  course  of  some 
putrid  or  continued  fever,  or  it  subjects  man  to  the 
manifold  dangers  of  A^enereal  or  tubercular  infections. 

In  advanced  age,  owing  to  the  diminution  in  size  of 
the  organ,  the  prepuce  resumes  the  proportionate  bulky 
dimensions  of  childhood,  and  as  the  organ  recedes  and 
becomes  more  and  more  diminutive,  the  prepuce  again, 
like  in  childhood,  begins  to  tend  to  phimosis  ;  the  urine 
of  the  aged  is  also  more  irritating  and  prone  to  decom- 
position or  putrefaction,  and  the  constant  state  of  moist- 
ure that  the  preputial  canal  of  the  aged  is  necessarily 
kept  in,  either  by  frequent  urination  or  the  incomplete 
emptying  of  the  urethra  that  is  peculiar  to  old  age,  and 
which  results  in  more  or  less  dribbling,  is  a  powerful 
fector  in  inducing  the  many  attacks  of  posthitis  and  bal- 
anitis, as  well  as  those  attacks  of  excoriation  and  eczema 
which  are  so  annoying  to  the  aged.  I  have  often  seen  such 
cases  happening  to  men  past  fifty,  who,  being  widowers, 
and  never  having  had  anything  of  the  kind,  as  well  as 
being  in  the  most  complete  ignorance  of  the  nature  of 
the  disease,  have,  from  delicacy  and  fear  that  the  disease 
might  induce  some  suspicions  as  to  their  conduct  in  the 
minds  of  those  whose  good  opinions  they  A^alue  above  all 
else,  gone  on  suffering  untold  miseries,  especially  if  the 
urine  were  in  the  least  diabetic. 

One  such  case  that  fell  under  my  observation  not 
only  produced  such  miserj^  as  to  entail  a  loss  of  rest 
and  of  appetite,  but  even  induced  such  a  disturbance  of 
assimilation  and  nutrition  that  the  resulting  h3'pochon- 
driacal  condition  that  developed  from  these  enervating 
causes  ran  the  patient  into  a  low  condition,  ending  in 
complete   prostration   of  all   vital   powers  and   death, 


286  History  of  Circumcision. 

without  the  intervention  of  any  other  disease.  The 
subject  was  a  timid,  retiring  man  of  about  lifty-five 
years,  and  this  was  the  first  and  only  time  tliat  the 
prepuce  had  ever  caused  liim  any  anno^^ance, — a  circum- 
stance whicli  greatly  preyed  upon  his  mind,  as  he  could 
not  disconnect  it  with  the  idea  that  it  must  be  suspected 
as  venereal,  although  he  had  always  led  a  most  continent 
life  since  the  death  of  his  wife.  This  is,  of  course,  an 
extreme  case;  but  as  it  is  a  result  beginning  in  a  certain 
condition,  be  it  an  extreme,  erratic,  or  infrequent  occur- 
rence, it  is,  nevertheless,  an  example  of  what  may 
happen  in  advanced  life,  even  where  the  prepuce  has 
never  before  been  a  source  of  the  least  disturbance  or 
annoyance.  Persons  who,  with  the  increase  of  years, 
are  also  liable  to  an  increase  of  adipose  tissue,  are  more 
subject  to  this  dwindling  down  of  the  penis  and  conse- 
quent elongation  of  the  prepuce,  with  all  the  attendant 
annoyances,  than  thin  or  spare  people. 

In  this  irritation  that  the  prepuce  is  liable  to  cause, 
we  have  not  only  to  encounter  the  dangers  that  its 
thickenings  or  indurations  may  bring  on  in  their  train, 
in  the  shape  of  cancer,  gangrene,  or  hj^pertrophies,  but 
other  and  no  less  serious  results  are  liable  to  follow  a 
herpetic  attack,  or  in  consequence  of  an  attack  of 
balanitis  or  posthitis.  The  d^^suria  attending  any  of 
these  conditions  may  be  the  initial  move  for  such  a  seri- 
ous complication  that  life  may  be  brought  to  a  sudden 
end,  even  in  infanc}'^,  to  say  nothing  of  the  ease  with 
which  life  is  taken  off  in  after  j^ears  and  in  old  age  ;  with 
debilitated  and  imperfect  kidney  action,  it  takes  very 
little  to  hustle  us  off  from  life's  foot-bridge. 

A  case  as  occurring  in  Henoch's  clinic,  already  men- 
tioned or  referred  to  in  a  previous  chapter,  shows  what  a 
simple  phimosis  is  capable  of  inducing.     In  the  history 


General  Systemic  Diseases  Induced  by  the  Prepuce.     281 

of  the  cuse  the  phimosis  and  the  resulting  retention  in 
the  preputial  cavity  no  doubt  were  the  causes  of  the  cal- 
culus found  there ;  and  the  succeeding  calculi  and 
abnormal  condition  of  the  urinarj'  organs,  we  can  safely 
assume,  were  a  snbsequent  creation  to  that  in  the 
prepuce.  The  case  is  taken  from"  Henoch's  "  Lectures 
on  Diseases  of  Children,"  Wood  Libraiy  edition,  page 
256,  and  is  as  follows  : — 

"A.  L.,  aged  two,  admitted  November  28,  1877. 
Quite  well  nourished,  but  pale.  Complete  retention  of 
urine  for  two  da}' s ;  slight  redness  and  marked  oedema 
of  penis,  scrotum,  and  perineum.  The  foreskin  cannot 
be  retracted,  on  account  of  phimosis.  Abdomen  dis- 
tended, hard,  and  sensitive,  the  dilated  bladder  extend- 
ing  a  few  fingers'  breadth  above  the  symphysis.  In 
order  to  introduce  the  catheter,  it  was  first  necessary  to 
operate  upon  the  phimosis,  during  which  a  calculus, 
which  completely  occluded  the  meatus,  was  removed. 
The  catheter,  when  introduced  into  the  bladder,  removed 
a  quantit}'  of  cloudy  urine.  The  oedema  rapidl}'  disap- 
peared under  applications  of  lead- wash,  but  on  Novem- 
ber 29tli  A'omiting  and  diarrhoea  occurred  daring  the 
night,  with  rapid  collapse;  December  1st,  death.  Au- 
tops}^ :  In  the  bladder,  a  sulphur-yellow  stone,  as  large 
as  a  hen's  egg,  completely  filling  the  organ ;  similar  cal- 
culi, from  the  size  of  a  pea  to  that  of  a  bean,  in  the 
pelvis  of  the  left  kidney  ;  right  kidnej-  normal." 

In  the  above  case,  the  oedema  of,the  penis,  scrotum, 
and  perineum  was  as  much  a  result  of  the  distension  of 
the  bladder  by  the  retained  urine  interfering  with  the 
return  circulation  from  the  oedematous  parts  as  the  dif- 
ferent appearances  of  diseased  conditions  were  a  result 
of  the  primary  phimosis  ;  yet  this  case,  if  seen  during  its 
early  infancy,  when  probably  the  contraction  of  the 

10 


288  History  of  Circumcision. 

preputial  orifice  was  as  j'et  not  so  well  marked,  would 
have  been  pronounced  one  in  which  it  would  be  needless 
and  barbarous  to  perform  circumcision  upon.  We 
would  most  assuredly  have  to  wander  aimlessly  and 
unprofitably  in  the  region  of  speculation  to  build  up  the 
etiology  of  the  abov'e-related  case  and  reach  the  cul- 
mination there  found,  unless  we  accept  the  one  that  it 
was  all,  from  first  to  last,  the  result  of  the  phimosis. 

Jonah,  pitched  overboard  at  sea  to  appease  the  tem- 
pest and  swallowed  by  the  whale,  became  convinced 
finally  that  he  had  better  return  to  Nineveh  to  preach 
reform  ;  while  Pharaoh  would  not  let  the  children  of 
Israel  depart  even  after  Moses  had  so  frightened  him — 
as  it  is  related  in  the  rabbinical  traditions  compiled 
by  the  Rev.  T.  Baring-Gould,  M.A. — that  the  royal 
bowels  were  completely  relaxed  at  the  sight  of  the 
snakes  turned  loose  about  the  royal  throne, — a  circum- 
stance which  nearly  lost  him  his  claim  to  divinity,  which 
was  based  on  the  fact  that  his  bowels  moved  only  once 
a  week,  as  in  this  case  they  not  only  moved  out  of  time 
and  in  the  most  unkingly  manner,  so  that  the  noble  king 
hid  underneath  the  throne,  but  before  even  Pharaoh 
could  disengage  himself  from  the  royal  robes,  which 
event  could  hardly  have  raised  him  in  the  estimation  of 
the  gentlemen  eunuchs  of  the  bed-chamber.  Those  who 
unwound  the  mummy  of  Pharaoh  tell  us  that  he  had  the 
appearance  of  a  self-willed,  despotic,  but  intelligent,  old 
gentleman;  but  the  above  rabbinical  relation,  from 
Baring-Gould's  "  Legends  of  the  Patriarchs  and  Pro- 
phets,." seems  to  have  had  no  convincing  effect  on 
Pharaoh  ;  so  we  must  not  be  surprised  if  even  a  case 
like  the  one  from  Henoch's  clinic  would,  with  many. 
carrry  no  conviction. 

In  the  second  volume  of  Otis  on  "  Geni to-Urinary 


General  Systemic  Diseases  Induced  by  the  Prepuce.     289 

Diseases,"  of  the  Birminghain  edition,  at  page  380,  there 
is  an  interesting  account  of  a  physician  who,  in  3'onth, 
was  troubled  with  an  annoying  prepuce,  which,  from 
frequent  attacks  of  balanitis,  had  finally  become  more 
or  less  adherent  to  the  glans  penis  ;  up  to  the  age  of 
nineteen  he  had  been  unable  to  completely  uncover  the 
glans.  B}^  six  months  of  hard  and  persistent  labor  he 
had  finally  broken  up  these  adhesions.  At  the  age  of 
twenty-two  he  married,  and  he  then  ruptured  the  frenum, 
which  bled  profusely  and  left  him  sore  for  some  days. 
Then  for  twent^^-seven  years  he  had  no  further  trouble, 
but  at  the  end  of  that  time  he  began  to  experience  what 
he  believed  were  attacks  of  dumb  ague,  and  the  scrotum 
began  to  swell  and  felt  sore  on  firm  pressure.  Heavy, 
aching  pains  then  followed.  This  condition  of  things 
lasted  for  over  five  years,  varied  by  the  appearance  of 
carbuncles  on  the  nose  and  elsewhere,  to  relieve  the 
monotony  of  the  thing.  From  this  time  on,  abscesses 
began  to  form  in  the  scrotum  and  into  the  integument 
of  the  penis,  burrowing  forward  into  the  prepuce,  which 
was  much  swollen  and  painful.  A  gangrenous  opening 
effected  itself  in  the  dorsal  surface,  which  relieved  him 
somewhat.  The  patient  was  finally  examined  by  Dr. 
Otis,  who  found  a  badl}'  strictured  urethra,  the  strict- 
ui'es  beginning  at  the  meatus,  and  at  intervals  extended 
down  as  far  as  two  and  three-fourths  inches.  The  ca,se 
had  no  venereal  history,  the  patient  never  having  had 
any  disease  or  anything  of  the  kind.  The  strictures 
were  plainly  the  result  of  the  balano-posthitic  attacks 
as  much  as  they  were  the  cause  of  the  degeneration  of 
the  mucous  membrane  in  the  lower  urethra,  that  allowed 
of  the  infiltration  of  urine  into  tlie  tissues,  which  caused 
all  the  systemic  disturbances,  abscesses,  miserj',  and 
agony  of  the  patient,  depriving  him  of  comfort,  sleep, 


390  History  of  Circumcision. 

ov  ability  for  labor,  and  which  sent  him  here  and  there 
In  search  of  health  and  relief. 

It  would  seem  really  as  if  a  prepuce  was  a  danger- 
ous appendage  at  any  time,  and  life-insurance  companies 
should  class  the  wearer  of  a  prepuce  under  the  head  of 
hazardous  risks,  for  a  circumcised  laborer  in  a  powder- 
mill  or  a  circumcised  brakemen  or  locomotive  engineer 
runs  actually  less  risk  than  an  uncircumcised  tailor  or 
watchmaker.  They  recognize  the  danger  that  lurks  in 
a  stricture,  but  what  a  prepuce  can  and  does  do,  they 
entirelj'^  ignoi*e.  I  have  not  had  any  opportunities  for 
comparison,  but  it  would  be  interesting  to  know,  from 
the  statistics  of  some  of  these  companies,  how  much 
more  the  Hebrew  is,  as  a  premium-payer,  of  value  to 
the  company  than  his  uncircumcised  brother.  Were 
thej^  to  offer  some  inducement,  in  the  shape  of  lower 
rates,  to  the  circumcised,  as  they  should  do,  ihey  would 
not  only  benefit  the  companies  by  insuring  a  longer 
number  of  j^ears,  on  which  the  insured  would  pay 
premiums,  but  they  would  be  instrumental  in  decreas- 
*  lug  the  death-rate  and  extending  longevit3^ 

I  have  seen  so  man}^  cases  of  stricture  whose  origin 
could  be  traced  to  balanitis  that  it  can  almost  with 
confidence  be  assumed  that,  wherever  there  is  a  long 
prepuce  with  a  red  and  inflamed  meatus  in  a  child, 
that  unfortunate  child  will  be  a  victim  of  fossal  stric- 
tures when  arrived  to  manhood,  and  that,  moreover,  he 
will  be  a  surer  victim  to  the  reflex  neuroses  which  so 
often  accompany  strictures,  and  which  have  been  so 
ably  described  by  Otis,  than  the  victim  of  uncompli- 
cated strictures  acquired  in  the  worship  of  Yenus. 
There  is  no  end  to  the  miser}'  that  these  poor  fellows 
have  to  suffer,  besides  the  habitual  hypochondriacal 
qonditiou  into  which  the  accompanying  physical  depres- 


General  Systemic  Diseases  Induced  by  the  Prepuce.     291 

sion  thi'ows  them ;  it  unfits  them  for  business,  any 
undertaking,  or  even  for  social  enjoyment  or  enter- 
tainment ;  they  keep  themselves  and  their  families  in 
continued  hot  water.  These  subjects  are,  also,  more 
prone  to  gout\'  and  rheumatic  aflPections,  asthma,  and 
other  neuroses. 

Among  the  manj^  cases  of  nervous  disorders  simu- 
lating other  diseases  that  I  have  seen  relieved  were  two 
Jewish  lads  with  an  imperfection  of  the  meatus.  They 
were  two  brothers,  and  from  the  history  of  the  cases, 
and  that  given  me  by  the  mother  of  the  lads  in  regard 
to  the  father,  the  malformation  must  hiive  been  hered- 
itar}'  and  congenital.  It  consisted  of  a  partial  occlusion 
of  the  meatus  by  a  false  membrane,  which  divided  the 
meatus  in  two,  horizontally,  but  which  was  closed  at  the 
posterior  end  of  the  lower  passage,  which  readily  ad- 
mitted a  probe  from  the  front  as  far  as  the  occlusion, 
about  a  third  of  an  inch  to  the  rear.  The  restoration, 
or  rather  the  making  the  anterior  urethra  and  meatus  to 
their  normal  condition,  relieved  both  boys  of  asthma, 
under  which  they  had  labored  for  years. 

The  many  cases  simulating  the  general  disturbances 
that  accompany  many  kidney  disorders,  that  are  simply 
the  result,  in  their  primary  causes,  of  preputial  irritation 
and  the  disturbances  to  the  kidney  function  due  to  the 
same  cause,  have  long  induced  me  to  look  upon  the  pre- 
puce as  a  great  and  avoidable  factor  to  some  of  the  many 
forms  of  kidney  diseases,  prostatic  enlargements,  vesi- 
cal diseases,  and  many  other  diseases  of  the  urinary 
organs,  which  we  know  full  well  can  result  from  stric- 
tures, as  the  latter  need  not  always  act  in  a  purely 
mechanical  mode  to  do  its  full  extent  of  mischief. 

One  result  of  these  preputial  irritations  not  generally 
or  particularly  mentioned  in  any  of  our  text-books — a 


292  History  of  Circumcision.  ■ 

condition  far-reaching  as  regards  its  own  results,  and 
more  annoj'iug  and  serious  tlian  it  appears  at  first  sight 
— usually  begins  with  a  reflex  irritability  of  the  anal 
sphincter  muscle,  or  a  rectal  irritation  of  the  same 
order,  which  in  time  produces  such  organic  change  that 
an  h^'pertrophied  and  irritable,  indurated,  unyielding 
muscle  is  the  result.  Agnew,  of  Philadelphia,  describes 
the  condition,  but  does  not  mention  tliis  frequent  cause 
under  the  name  of  sphincterismus  ;  once  this  is  estab- 
lished, tlie  train  of  resulting  pathological  or  diseased  con- 
ditions that  may  follow  are  without  end.^"^  This  is  no 
fancy  sketch,  nor  will  the  student  of  the  pedigree  and 
origin  of  diseases  feel  that  the  case  is  exaggerated  or 
imaginative.  These  are  some  of  those  cases  that  are 
always  ailing,  never  well  and  really  never  sick,  but  who 
are,  nevertheless,  gradually  breaking  down  and  finally 
die  of  what  is  termed  "  a  complication  of  diseases," 
before  living  out  half  their  term  of  life. 

How  this  happens  is  simple  enough — the  straining 
required  to  produce  an  evacuation  is  out  of  all  proportion 
with  the  character  of  the  discharge;  such  patients  often 
complain  of  being  constipated  when  the  evacuations  are 
semi-fluid  ;  this  straining  is  followed  by  a  dilatation  and 
consequent  loss  of  power  of  the  rectum,  which  becomes 
pouched  and  its  mucous  membrane  thickened ;  the 
whole  intestinal  tract  sympathizes  and  digestion  is  in- 
terfered with,  and  the  forcible  expulsive  efforts  affect 
all  the  abdominal  and  thoracic  organs  in  a  more  or  less 
degree,  laying  the  foundation  for  serious  organic  dis- 
eases. Now,  this  condition,  which  may  be  said  to  be  no 
more  than  one  of  obstinate  constipation,  is  a  far  more 
reaching  condition  and  a  far  more  injurious  state  than 
can  be  imagined  at  a  first  glance.  Constipation  is  not, 
as  a  rule,  always  accompanied  by  the  indigestion,  either 


General  Systemic  Diseases  Induced  by  the  Prepuce.     293 

stomachic  or  intestina,!,  that  goes  with  this  condition  ; 
the  contents  of  the  intestines  in  simple  constipation  may 
simply  lack  fluidity  without  undergoing  putrefactive  fer- 
mentation, but  in  this  condition  the  undigested  and 
retained  intestinal  contents  do  undergo  that  change,  re- 
sulting in  the  generation  of  material  whose  re-absorp- 
tion produces  a  toxic  condition  of  the  blood,  from 
whence  begins  a  series  of  serious  organic  changes  in  the 
blood,  and  from  this  in  the  organs. 

To  the  practical  physician  these  changes  are  evident 
and  their  cause  just  as  plain,  and  it  is  just  here  where 
the  laity  lack  the  proper  education,  and  where  they 
should  understand  that  the  intelligent  ph3'sician  general- 
izes the  disease  and  only  individualizes  the  patient; 
and  it  is  this  ignorance  on  the  part  of  the  \si\ty  that 
gives  to  empiricism  and  quackei'y  that  advantage  over 
them,  as  thej^  look  upon  all  disease  as  a  distinct  indi- 
vidual ailment,  that  should  have  an  equally  distinct  and 
individual  therapeutic  agent  to  cope  singly  with.  The 
laity  know  very  little  of  these  things,  and  in  their 
happy  ignorance  care  still  less  for  the  finer  definitions 
of  or  of  the  clinical  importance  of  toxaemia,  or  the 
processes  of  abnormal  conditions  that  lead  up  to  such 
a  state,  or  the  results  that  may  follow  when  that 
condition  is  once  reached.  To  them,  dyspepsia  is  an 
indigestion  ascribable  to  the  stomach,  and  a  sick-head- 
ache is  ascribed  to  something  wrong  about  the  stomach 
or  liver. 

The  laity  have  never  been  called  upon  to  answer  the 
questioning  of  the  late  Prof.  Robley  Dunglison  :  "What 
do  you  mean,  sir,  by  biliousness?  Do  you  mean,  sir, 
that  the  liver  does  not  secrete  or  manufacture  a  suflfl- 
ciency  of  bile,  or  not  enough  ?  Do  you  mean  that  the 
bile-material  is  left  in  the  blood,  or  too  much  poured  in  ? 


294  History  of  Circumcision. 

Do  3'ou  mean  that  there  is  an  excess  in  the  alimentary 
canal,  and  a  deficiency  elsewhere  ?  Please,  sir,  explain 
what  you  really  mean  by  the  term  '  bilious  1' "  The 
Professor  had  a  waj'^  about  him  that  at  least  made  one 
stop  and  seriously  inquire,  before  adopting  any  random 
notion  in  regard  to  medicine.  It  is  to  be  regretted  that, 
in  the  humdrum  tread-mill  work  of  many  phj^sicians, 
they  even  have  to  drop  into  the  commonplace  way 
of  treating  dyspepsias  and  such  ailments  without  any 
further  inquiry.  A  farmer  knows  better  than  to  drive 
a  dishing  wheel,  or  with  merely  having  a  nail  clinched 
in  the  loose  shoe  of  a  valuable  horse ;  but  he  is  fully 
satisfied  to  do  so  in  a  metaphorical  sense,  as  regards  his 
own  constitution,  and  the  mere  hint  from  his  physician 
that  he  had  better  lay  up  for  repairs,  or  that  there  is 
'  something  wrong  about  him  that  will  require  investiga- 
tion, and  that  there  is  an  ulterior  cause  to  his  feeling 
tired,  headachj?^,  or  dyspeptic,  or  an  allusion  that  there 
is  something  sj^stemic,  as  a  cause,  to  his  momentaiy 
attacks  of  disordered  vision  or  amaurosis,  will  generally 
make  him  look  on  the  doctor  with  mistrust. 

The  merchant,  banker,  and  mechanic  are  not  up  to 
Professor  von  Jaksch's  ideas  of  toxaemia, — that  toxsemia 
may  be  exogenous  or  endogenous,  or  that  the  latter  is 
further  subdivided  into  three  more  varieties, — and,  what 
is  worse,  he  cares  still  less.  The  above  three  classes  of 
humanity,  when  sick,  simply  would  want  to  know  if  Pro- 
fessor von  Jaksch  was  good  on  dj'spepsia,  the  measles, 
or  typhoid  fever.  They  care  ver3'  little  that  he  divides 
endogenous  or  auto-toxsemia  into  that  produced  by  the 
normal  products  of  tissue-interchange,  abnormally  re- 
tained in  the  body,  giving  rise  to  uraemia,  toxssmia  from 
acute  intestinal  obstruction,  etc.,  the  above  being  the  first 
division.     The  second  depends  on  the  outcome  of  patho- 


General  Systemic  Diseases  Induced  by  the  Prepuce.     295 

logical  processes,  which  change  the  normal  course  of 
assimilation  of  food  and  tissue-interchange  ;  so  that,  in- 
stead of  non-toxic,  toxic  matter  is  formed.  The  second 
group  he  names  noso-toxicoses,  which  he  subdivides  into 
two  principal  divisions  : — 

(a)  The  carbohydrates,  fats,  or  albuminous  matter, 
which  may  be  decomposed  abnormall}'  and  give  rise  to 
toxic  products,  e.gr.,  diabetic  intoxication,  coma  carcino- 
matosum. 

(6)  A  contagium  vivum  enters  the  body  through  the 
skin,  or  the  respiratory  or  digestive  tract,  and  develops 
toxic  agents  in  the  tissues  on  which  it  feeds,  as  in  infec- 
tious diseases. 

In  the  tliird  group  the  toxic  substance  results  from 
pathological  non-toxic  products,  which  again  produce  a 
toxic  agent,  only  under  certain  conditions.  This  group 
he  calls  auto-toxicoses,  and  includes  in  it  poisonous  sub- 
stances, resulting  from  decomposition  of  the  urine  in 
the  bladder,  under  certain  pathological  conditions,  and 
giving  rise  to  the  condition  called  ammoniaemia.  (Medi- 
cal News  of  January  Y,  1891  ;  from  Wiener  klinische 
Wochenschrift  of  December  25, 1890.) 

As  observed  above,  unfortunately  the  patients  know 
nothing,  nor  can  they  be  made  to  understand  these  con- 
ditions, that  are  onl}^  reached  through  labj'rinthic  patho- 
logical processes,  and,  what  is  still  worse,  this  way  of 
looking  at  disease  is  incompatible  with  the  idea  of  spe- 
cific-disease treatment,  which  to  them  looks  more  prac- 
ticable and  quick,  and  which  is  also  more  to  their 
liking.  They  cannot  see  any  sense  in  such  reasoning, 
which  to  them  is  something  eminently  impracticable ; 
neither  can  they  see  a  reasonable  being  in  the  doctor 
who  practices  on  such,  as  they  call  tliem,  theories. 

The  practical  physician,  however,  sees  in  Professor 


21)6  History  of  Circumcision. 

Von  Jaksch's  summary  the  turning-point  of  manj'  a  poor 
fellow's  career, — from  one  of  comparative  health  into 
one  of  organic  disintegration,  decay,  and  dissoluti(>n, — 
all  the  required  processes  starting  visibly  from  the  very 
smallest  of  beginnings ;  any  obstruction  in  the  urinary 
tract  or  intestinal  canal  being  sufficient  to  start  an3^  of 
the  conditions  which  end  in  toxaemia;  and,  from  a  care- 
ful observation  running  over  several  years,  I  do  not 
think  that  I  am  assuming  too  much  in  saying  that  a 
balanitis  is  often  the  tin}^  match  that  lights  the  train 
that  later  explodes  in  an  apoplectic  attack  or  sudden 
heart-failure  due  to  toxaemia ;  the  organic  and  vascular 
s^'^stems  being  gradually  undermined  until,  unannounced 
and  unawares,  the  ground  gives  way  and  the  final  catas- 
trophe occurs, — unfortunately,  an  occurrence  or  ending 
looked  upon  as  unavoidable  by  the  friends  of  the 
victim.  The}^  cannot  see  any  danger ;  the  idea  that  dis- 
eases have  the  road  paved,  not  only  for  an  easy  entrance 
biit  an  easy  conquest,  b}'^  the  action  of  these  toxic 
agents  on  the  tissues,  is  something  that  the}'  cannot 
grasp.  These  blood  changes  or  blood  conditions  are 
things  too  intricate,  and  the  physician  who  understands 
them  is,  to  them,  a  visionary  and  unpractical  man. 
These  conditions  are,  however,  neither  new  nor  unknown, 
and  there  is  really  no  excuse  for  the  ignorance  exhibited 
in  these  matters  by  the  general  public,  as  it  i*s  through 
the  blood  that  this  mischief  takes  place.  They  can 
reason  in  their  impotent  way,  that  they  should  drench 
themselves  with  "  blood  tonics "  and  all  manner  of 
nauseous  compounds  to  "  purif}'  "  their  blood,  but  the 
simple,  scientific  truth  is  something  beyond  their  under- 
standing, as  well  as  something  that  they  steel  themselves 
against. 

Sir  Lionel  Beale,  in  observing  the  immense  impor- 


General  Systemic  Diseases  Induced  by  the  Prepuce.     29T 

tance  he  attaches  to  blood  composition  and  blood  change 
in  diseases  of  various  organs,  truly  remarks  that  "  blood 
change  is -the  starting-point,,  and  may  be  looked  upon  as 
the  cause,  of  what  follows,"  the  other  factor  being  the 
" '  tendency  '  or  inherent  weakness  or  developmental 
defect  of  the  organ  which  is  the  subject  of  attack;"  to 
which  he  adds  that  he  feels  convinced  that,  if  only  the 
blood  could  be  kept  right,  thousands  of  serious  cases  of 
illness  would  not  occur ;  while  the  persistence  of  a 
healthy  state  of  the  blood  is  the  explanation  of  the  fact 
that  many  get  through  a  long  life  without  a  single 
attack  of  illness,  although  they  may  have  several  weak 
organs  ;  and  that  an  altered  state  of  the  blood,  a  depart- 
ure from  the  normal  ph3'siological  condition,  often 
explains  the  first  step  in  many  forms  of  acute  or  chronic 
disease.  Sir  Lionel  has  been  a  pioneer  in  the  field  of 
thought  that  looks  for  the  cause  of  the  disease,  which, 
however  remote  it  may  be,  should  not  be  overlooked  as 
a  really  primary  affection.  His  extensive  labor  in  the 
microscopic  field  has  fully  convinced  him  that  many  of 
the  pathological  changes  in  the  different  organs  are  due 
to  what  might  be  called  some  intercellular  substance 
that  is  deposited  from  the  blood.  (Beale  :  "  Urinary 
and  Renal  Disorders.") 

Toxic  elements  in  the  blood  affect  the  kidneys  in  a 
greater  or  less  degree,  and  there  produce  changes  at 
first  unnoticed, — at  least,  as  long  as  the  kidney  can  per- 
form its  function, — but  the  day  arrives  when,  as 
described  by  Fothergill,  blood  depuration  is  imperfect, 
and  we  get  many  diseases  which  are  distinctly  ursemic 
in  character,  and  ending  in  any  of  the  so-called  kidney 
diseases,  Bright's  disease  being  one  of  the  most  com- 
mon. As  observed  b}'  Fothergill,  however,  the  kidne}' 
is  not  the  starting-poiut,  the  new  departure  only  taking 


298  History  of  Circumcision. 

place  when  the  structural  change  on  the  kidney  has 
reached  that  point  that  it  is  no  longer  equal  to  its  func- 
tion— the  "  renal  inadequacy  "  of  Sir  Andrew  Clarke. 
(J.  Milner  Fothergill,  in  the  Satellite,  February,  1889  ) 

During  the  Bradshawe  lecture,  Dr.  William  Carter 
made  the  following  remarks  :  "According  to  Bouchard, 
one-fifth  of  the  total  toxicitj'  of  normal  urines  is  due  to 
the  poisonous  products  re-absorbed  into  the  blood  from 
the  intestines,  and  resulting  from  putrefactive  changes 
which  the  residue  of  the  food  undergoes  there."  In 
the  course  of  the  lecture,  Dr.  Carter  fully  explains  that 
one  of  the  benefits  derived  from  milk  diet  in  Bright's 
disease  is  the  small  residuum  deficient  in  toxic  proper- 
ties, and  lays  great  stress  on  the  employment  of  intes- 
tinal disinfectants  or  antiseptics  that  exercise  their 
influence  throughout  the  whole  tract,  suggesting  naph- 
thalin  as  peculiarly  efficacious,  thereb}^  cutting  off  one 
source  of  blood  contamination  at  its  source.  Although 
these  are  recent  developments  in  medicine,  Bouchard 
mentions  that  in  the  practice  of  M.  Tapret  cases  treated 
on  this  principle  did  well.  (Braithwaite's  Retrospect, 
January,  1889.) 

Persons  laboring  under  this  toxic  condition  of  the 
blood,  with  a  consequent  deterioration  in  the  texture 
and  the  physiological  function  of  the  vital  organs, 
are  of  that  class  that  easily  succumb  to  injuries  or 
serious  sickness,  and  of  that  class  to  whom  a  surgical 
operation  of  even  medium  magnitude  is  equal  to  a 
death-warrant. 

The  above  conditions  are  an  almost  constant  attend- 
ant on  that  condition  of  the  sphincter  described  by 
Agnew  as  sphincterismus,  which  also  is  productive  of 
haemorrhoids  and  fissure,  and  often  of  fistula.  That 
sphincterismus   is  caused  in  many  cases  b^'  preputial 


General  Systemic  Diseases  Induced  by  the  Prepuce.     299 

irritation  is  as  evident  as  that  the  same  affection,  or 
haemorrhoids  or  any  other  rectal  or  anal  aflection,  will, 
in  its  turn,  produce  vesical  and  urethral  reflex  actions, 
and  primarily  functional  and  secondaril3'  organic  changes 
in  those  parts.  Besides,  the  great  number  of  cases 
wherein  the  gradual  and  progressive  march  of  each 
pathological  event  could  be  traced  with  accuracy  has 
convinced  me  of  the  true  cause  of  the  difficulty  being 
the  result  of  reflex  irritation. 

Delafield,  in  his  "  Studies  in  Pathological  Anatomy," 
gives,  as  the  first  form  of  pneumonia,  that  from  heart 
disease ;  in  the  days  of  Broussais  this  would  have 
sounded  absurd,  but,  to-day,  some  forms  of  heart  disease 
are  known  to  be  the  regular  sequences  of  some  particu- 
lar form  of  kidney  disease,  just  as  some  form  of  pneu- 
monia attends  an  affected  heart  and  that  some  forms  of 
pneumonia  degenerate  into  phthisis.  When  the  blood 
change  is  an  established  fact,  it  is  only  a  question  as  to 
which  is  the  weak  organ,  and  the  organism  of  the 
individual  will  decide  whether  it  will  be  a  simple  sick- 
headache  or  the  beginning  of  a  pneumonia  ending  in 
phthisis. 

I  have  purposely  dwelt  on  this  part  of  this  subject, 
owing  to  the  recent  origin  and  publication  of  man}^  of 
the  views  connected  with  it ;  also  on  account  of  the 
greater  ease  of  making  the  subject  plain  by  fully  dis- 
cussing each  step  of  the  process;  and  if  the  views  of 
Sir  Lionel  will  be  recalled,  that  a  toxic  element  in  the 
blood  is  the  starting-point,  and  that  an  irritable  or  weak- 
ened organ  invites  destruction, — the  induction  of  serious 
and  fatal  kidney  disorder  by  the  transmitted  irritability 
and  consequent  injury  to  the  kidney  produced  by  pre- 
putial irritation  in  the  first  instance,  and  the  supple- 
mental blood-poisoning  by  intestinal  absorption  of  septic 


300  History  of  Circumcision. 

matter,  wliicli  soon  brings  about  Sir  Andrew  Clarke's 
*'  inadequacy  of  kidne^^," — all  will  be  readily  understood. 
"When  this  point  is  reached,  a  too  hearty  meal,  exposure 
to  variable  weather,  or  a  little  extra  care  or  anxiety, 
are  sufficient,  as  determining  causes,  to  bring  life  into 
danger. 

As  pointed  out,  many  cases  of  Bright's  disease  or 
other  renal  difficulty  have  their  origin  in  this  distant  but 
visible  source,  and,  although  malarial  poisoning  and  a 
great  number  of  other  causes  will  produce  the  same 
particular  organic  changes  and  diseases,  this  condition 
must  be  admitted  as  one  of  the  frequent  causes.  The 
influence  of  the  genito-urinary  tract  on  the  rest  of  the 
economy,  and  the  importance  of  the  sympathy  it  excites, 
or  how  quickl^'^,  by  its  being  irritated,  some  apparently 
dormant  pathological  condition  will  be  awakened  to  life 
and  activit}'^,  is  not  sufficiently  appreciated.  As  observed 
by  Hutchinson,  a  patient  who  has  once  been  the  subject 
of  intermittent  fever  is  more  prone,  on  catheterization, 
to  have  a  urethral  chill  and  fever  tlian  one  who  had  never 
had  the  fever.     (Hutchinson  :  "Pedigree  of  Diseases.") 

Ralfe  observes,  in  his  "  Kidne}'^  Diseases,"  that  long- 
standing disease  of  the  genito-urinary  passages  must  be 
reckoned  as  among  the  chief  etiological  factors  of  chronic 
interstitial  nephritis  (page  221).  The  condition  of  the 
kidneys  in  cases  of  strictures  of  long  standing  is  known 
not  to  be  a  reliable  one,  and  any  incentive  to  dysuria  or 
to  retention,  no  matter  how  slight,  is  apt  to  lead,  eventu- 
ally— and  that  even  in  very  young  subjects — to  that 
toxic  condition  mentioned  in  a  former  part  of  this  chap- 
ter as  one  of  von  Jaksch's  subdivisions  of  toxaemia,  the 
animoniaemia  of  Frerichs  ;  this  condition  being  the  fatal 
ending  of  the  case  of  the  two-j^ear-old  child  mentioned 
b}^  Henoch,  who  died  after  the  relief  of  a  retention  due 


General  Systemic  Diseases  Induced  by  the  Prepuce.     301 

to  phimosis  and  calculi  resulting-  from  the  phimotic 
occlusion.  Having  seen  so  many  cases  wherein  the  con- 
ditions described  in  this  chapter  were  so  apparently — 
whether  from  ammonisemia  due  to  infection,  or  toxaemia 
from  the  urinary  tract,  or  ursemic  toxaemia  from  the 
intestinal  tract — all  due  to  some  preputial  interference 
or  irritation,  I  cannot  help  but  feel  that  in  these  con- 
ditions— which,  singularly,  are  not  so  prevalent  with  the 
Hebrews  as  with  Christians — we  have  one  factor  in  the 
cause  of  the  shorter  and  more  precarious  vitality  of  the 
latter. 

Morel, in  his  "  Traite  des  Degenerescenees  Phisiques," 
ably  discusses  the  degenerative  and  morbific  influences 
and  results  of  toxaemia,  as  well  as  he  clearly  defines 
their  sources.  The  connection  between  toxaemia  and 
mental  affections  has  already  been  shown,  and  Prof. 
Hobart  A.  Hare,  in  his  instructive  and  interesting 
prize  essay  on  "  La  Pathogenic  et  la  Therapeutique  de 
I'Epilepsie  (Bruxelles,  1890),  mentions  that  convulsive 
disorders  resulting  from  the  presence  of  some  toxic 
substance  are  of  frequent  occurrence.  How  mucli  this 
may  enter  as  a  partial  factor  into  many  of  the  cases  of 
epilepsy  which  are  classed  in  the  order  of  "  reflex  "  may 
well  challenge  our  consideration.  Hare  lays  great  stress 
on  the  necessity  of  circumcision  wherever  there  is  an 
indication  of  preputial  local  irritation.  "  If  practicable, 
circumcision  should  be  performed;  it  is  an  operation 
with  but  small  risk  or  danger,  and  easy  of  performance. 
In  such  circumstances  it  is  always  permissible  to  cir- 
cumcise, were  it  for  no  other  end  than  an  acknowledged 
attempt  to  reach  a  cure." 


CHAPTER  XXYI. 

Surgical  Operations  Performed  on  the  Prepuce. 

In  operative  interference  tliere  is  one  point  which 
should  not  be  lost  sight  of,  this  being  that  the  length 
and  bulk  of  the  prepuce  in  a  great  measure  depends  on 
the  constriction  at  its  orifice ;  if  the  orifice  is  small,  the 
prepuce  tight  and  inelastic,  every  erection,  b}'  putting 
the  penis-integument  on  the  stretch,  adds  to  its  bulk, — 
nature  naturally  trj- ing  to  make  up  the  deficienc}', — the 
two  points  of  resistance  being  where  the  glans  pushes 
it  ahead,  having  the  constricting  orifice  for  a  hold  or 
purchase,  and  the  skin  at  the  pubes,  which  is  called 
upon  to  furnish  the  extra  tissue  for  the  time  being 
needed  during  erection,  which  should  be  supplied  by  the 
pi-epuce — tliis  being  the  onl}-  ofiice  which  I  have  been 
able  to  assign  to  this  otherwise  useless  but  ver}-  mis- 
chievous appendage.  In  cases  where  preputial  irritation 
produces  more  or  less  priapism,  the  continued  stretching 
of  this  integument  causes  a  marked  increase  in  its 
growth,  which  is  mostly  added  forward.  It  was  on  this 
principle  or  its  recognition,  that  Celsus  devised  his 
operations,  and  on  which  the  persecuted  Jews  under- 
took to  recover  their  glans  by  manufacturing  a  prepuce; 
and,  although  the  trial  was  not  reported  as  being  very 
successful,  I  do  not  doubt  but  that,  if  the  skin  could  have 
been  drawn  sufficiently  over  so  as  to  constrict  it  ante- 
riorly so  as  to  give  the  glans  a  purchase,  as  in  the 
case  of  phimosis  with  an  inelastic  prepuce,  the  opera- 
tion could  be  more  of  a  success;  all  that  is  required  is 
the  continued  extension  and  the  prepuce  might  be  made 
(302) 


Surgical  Operations  Performed  on  the  Prepuce.     303 

to  rival  in  length  the  labia  majorse  of  the  females  of 
some  African  tribes,  or  the  pendulous  buttocks  of  the 
Hottentot  Venus. 

I  have  employed  the  knowledge  of  this  elasticity 
and  source  of  supply  of  the  penis-integument,  on  more 
than  one  occasion,  in  recovering  the  denuded  organ  with 
skin.  A  number  of  cases  are  on  record  where,  owing 
to  the  want  of  that  artistic  and  mechanical  knowledge 
without  which  no  surgeon  is  perfect,  the  operator 
has  drawn  forward  the  skin  too  tight  in  circum- 
cising, after  which,  owing  to  the  natural  elasticity  of 
th«  skin,  the  integument  has  retracted,  leaving  the  penis 
like  a  skinned  eel  or  sausage.  This  accident  is  even 
liable  to  occur  where  the  skin  has  not  been  tightly 
drawn,  but  where  subsequent  erections  have  torn 
through  the  sutures,  and  where  the  natural  retraction 
of  the  skin  has  laid  the  organ  bare  for  some  distance. 
I  liave  seen  a  number  so  recorded,  but  do  not  remember 
seeing  any  remedy  suggested,  it  seemingly  being  ac- 
cepted that  the  recovery  must  take  place  by  gradual 
granulation, — a  necessaril}'^  "^'ery  slow  process,  owing  to 
the  constant  interference  by — the  always  present  in  such 
cases — unavoidable  erections. 

Several  years  ago  I  advised  circumcision  to  a  gentle- 
man owing  to  a  contracted  condition  of  the  muscles  of 
one  hip  and  thigh,  which  was  threatening  to  render  him 
a  deformed  cripple;  he  had  a  congenital  phimosis  and  a 
very  irritable  glans  penis.  The  operation  was  per- 
formed in  a  proper  manner  by  a  surgical  friend,  but  this 
friend,  unfortunately,  was  a  great  believer  in  antiseptic 
and  wet  dressings.  A  few  da3's  after  the  operation  he 
called  upon  me  to  ask  me  to  go  and  see  the  patient,  as 
they  were  both  in  a  pickle,  the  patient  being  exceed- 
ingly angr^^,  being  in  constant  miserj',  and  the  penis  so 


304  History  of  Circumcision. 

denuded  by  the  giving  way  of  tlie  sutures — owing  to 
the  erections — that  it  looked  to  the  patient  as  if  he 
never  could  have  a  whole  penis  again,  and  the  doctor 
saw  no  way  out  of  the  difficulty  ;  the  penis  was,  in 
reality,  a  dilapidated  and  sorrowful-looking  append- 
age, and  anything  else  but  a  thing  of  beauty  or  pride  ;  it 
was  raw,  angry -looking,  and  bleeding  at  every  move;  the 
first  wink  of  sleep  was  followed  by  an  attempt  at  erec- 
tion that  raised  the  patient  as  effectually  as  an  Indian 
would  in  scalping  him  ;  so  that,  taken  altogether,  the 
penis,  anxious  countenance,  and  the  flexed  position  of 
the  whole  body  to  relieve  the  tension  on  the  organ, 
the  man  looked  about  as  battered,  cast  down,  and  sor- 
rowful as  Don  Quixote  did  in  the  gari'et  of  the  old 
Spanish  inn,  with  his  plastered  ribs  and  demolished 
lantern-jaw. 

Luckily,  the  patient  was  seen  before  the  retracted  por- 
tion of  the  penile  integument  had  had  acbance  to  condense 
and  indurate.  The  bed  was  slopping  wet  with  the  drench- 
ings  of  carbolized  water  that  the  penis  had  undergone, 
the  man's  clothing  was  necessarily  damp,  and  the  wliole 
bedding  and  clotlies  were  steamy, — all  of  which  greatly 
added  to  his  discomfort  and  tendency  to  erections.  The 
man  was  washed,  placed  in  a  new,  clean,  and  dr}^  bed, 
and  his  clothing  changed.  The  organ  was  then  forced 
backward  until  the  preputial  frill  or  edge  was  approxi- 
mated to  the  cut  end  of  the  penis-skin,  where  it  was 
made  fast  by  an  uninterrupted  suture  around  the  whole 
of  the  circumference.  A  short  catheter,  about  three 
inches  in  length, — the  catheter  being  as  full  size  as  the 
urethra  would  comfortably  hold,  and  of  the  best  and 
thickest  of  the  red,  stiff"  variety, — was  introduced  into 
the  urethra.  This  protruded  about  half  an  inch  be3'ond 
the  meatus.     A   stiff",   square  piece  of  card-board  was 


Surgical  Operations  Performed  on  the  Prepuce.     305 

pierced  and  slipped  over  tliis,  and  then  adhesive  rubber 
straps  were  brought  from  the  integument  to  this  little 
platform,  the  first  being  from  the  median  line  of  the 
scrotum,  lifting  the  sac  forward  and  upward.  The 
pubes  were  shaved  and  the  next  four  straps  started 
from  the  root  of  the  penis,  each  strap  being  split  at  the 
glans-end  so  as  to  encircle  the  protruding  end  of  the 
catheter.  By  these  means  the  sk.m  was  brought  back 
and  firmly  supported  over  the  penis,  toward  the  glans  ; 
and,  in  case  of  any  erection,  the  act  would  only  assist 
in  drawing  the  covering  farther  over  the  penis,  as  the 
pasteboard  platform  and  adhesive  straps  formed  the 
distal  end  of  an  artificial  phimosis.  The  catheter  allowed 
of  free  urination,  and  the  scrotum  was  further  held  up 
in  position  by  a  flat  suspensorj'^  bandage  passed  under- 
neath the  scrotum  and  fastened  over  the  abdomen  neat 
each  hip.  The  penis  wound  was  then  dressed  with  a 
very  little  benzoated  oxide-of-zinc  ointment  passed 
between  the  adhesive  straps  ;  a  bridge-supiwrt  placed 
over  the  hips  to  support  the  bed-clothes,  and  all  was 
finished,  and  full  doses  of  bromide  of  sodium  and 
chloral  were  ordered  at  bed-time.  When  the  dressings 
were  removed,  five  days  afterward,  all  was  healed,  the 
sutures  removed,  and  the  suspensory  alone  replaced. 
The  patient  had  not  been  troubled  with  any  more  erec- 
tions or  annoj'ances  of  any  kind.  These  are  the  points 
which  often  do  more  or  less  mischief :  wet  dressings  are 
uncomfortable  and  favor  erections,  while  the  effect  of 
the  weight  and  action  of  the  scrotum  in  drawing  back- 
ward on  the  integument  should  not  be  overlooked ;  in 
addition,  it  should  not  be  overlooked  that  we  have  it  in 
our  power  to  produce,  so  to  speak,  an  artificial  phimotic 
action,  which  has  the  same  traction  on  the  penis-integu- 
ment that  the  natural  phimosis  induces. 


306  History  of  Circumcision. 

The  foregoing  method,  to  be  used  in  these  cases,  has 
proved  \evy  serviceable  in  my  hands,  and  it  is  here  given 
that  it  nia}'  assist  others  ;  as  there  is  no  need  of  waiting 
for  granulations  or  of  allowing  the  patient  to  undergo 
so  much  miser}',  which,  besides  the  local  injury,  cannot 
help  but  affect  the  general  health  very  injuriously.  The 
penis  can  stand  any  amount  of  forcing  backward  ;  it 
stands  tliis  in  cancer  or  hypertrophy  of  the  prepuce,  or 
ill  the  inflammatory  thickenings  that  precede  gangrene 
of  the  prepuce,  in  any  extended  degree ;  becoming,  for 
the  time  being,  more  or  less  atrophied.  As  has  been 
shown  by  Lisfranc,  the  penis  can  be  made  nearly  to  dis- 
appear into  the  pubes  ;  so  that  we  are  not  as  helpless  in 
these  cases  as  our  text-books  would  have  us  believe. 

In  infants,  and  in  young  children  below  the  age  of 
ten  or  twelve,  the  Jewish  operation,  as  modified  and 
done  in  accordance  Avith  the  dictates  of  modern  surgery, 
will  be  found  the  most  expedient.  By  this  method  we 
avoid  the  need  of  any  anaesthetic  agents,  which  are 
more  or  less  dangerous  with  children,  as  Avell  as  the 
need  of  sutures,  which  are  painful  of  adjustment  and 
verv  annoying  to  remove  in  those  little  fellows  who 
dread  new  harm  ;  there  is  also  much  less  risk  of  haemor- 
rhages, as  the  frenal  artery  is  not  wounded.  In  children 
of  a  year  or  over,  a  very  good  result  will  be  found  often 
to  follow  Cloquet's  operation,  care  being  taken  to  carry 
the  slitting  well  back,  as  well  as  care  in  taking  it  on  one 
side  of  the  frenum,  so  as  to  avoid  any  wound  of  that 
artery,  the  subsequent  dressing  being  a  small  Maltese- 
cross- bandage,  pierced  .so  as  to  admit  the  glans  to  pass 
through ;  the  prepuce  is  retracted  and  the  tails  folded 
over  each  other  and  held  there  by  a  small  strip  of  rubber 
adhesive  plaster ;  a  little  vaselin  prevents  tlie  soiling 
by  urine  underneath.     This  last  operation  is  short  and 


Surgical  Operations  Performed  on  the  Prepuce.     307 

very  easj^,  is  not  painful,  nor  does  it  require  much 
manipulation  ;  it  is  only  one  quick  cut  on  the  grooved 
director  and  it  is  over  ;  by  the  retraction  of  the  prepuce, 
the  longitudinal  cut  becomes  a  transverse  one,  making 
the  prepuce  wider  and  shorter  at  once ;  the  glans  soon 
develops  and  remains  uncovered.  As  there  is  a  very 
small  wound  to  heal  over,  the  repair  is  very  prompt. 

In  adults  with  a  very  narrow,  thin,  not  overlong 
prepuce,  a  very  good  result  often  follows  a  combination 
of  the  dorsal  slit  with  the  inferior  slit  alongside  of  the 
frenum  of  Cloquet,  The  narrower  and  tighter  the  pre- 
puce, the  better  the  result,  as  the  cuts  are  at  once  con- 
verted from  longitudinal  into  transverse  wounds,  and 
the  organ  at  once  assumes  the  shape  and  condition  of  a 
circumcised  organ,  without  having  suffered  any  loss  of 
substance ;  three'  stitches  or  sutures  in  each  cut  (silver 
or  catgut)  adjust  the  cut  edges;  a  small  roller  of 
lint  and  adhesive  plaster,  placed  so  as  to  shoulder  up 
against  the  corona,  completes  the  dressing.  Where  this 
operation  is  practicable,  by  the  thinnes  and  narrowness 
of  the  prepuce,  it  has  many  advantages.  I  have  re- 
peatedly performed  it  on  lawyers,  book-keepers,  clerks, 
and  even  laboring  men,  who  have  gone  from  the  office 
to  the  courts,  counting-rooms,  or  stores  without  the 
least  resulting  inconvenience  or  loss  of  time.  In  labor- 
ers it  is  better  to  perform  the  operation  on  a  Saturday 
evening,  which  gives  tliem  a  rest  of  thirty-six  hours  be- 
fore going  to  their  labor  again.  The  operation  is  com- 
paratively painless  and  almost  bloodless,  as  there  need 
not  be  more  than  half  a  teaspoonful  of  blood  lost  during 
the  operation  ;  there  is  no  danger  of  any  subsequent 
haemorrhage,  and,  with  proper  precautions  against  the 
occurrence  of  erections,  from  seventy-two  to  ninety-six 
hours  is  sufficient  for  a  complete  union ;  the  sutures  are 


308  History  of  Circumcision. 

then  removed  and  a  simple  lint  and  adhesive-plaster 
dressing  worn  for  a  few  days  more.  In  many,  no  more 
dressings  are  required.  In  many  cases,  with  a  properly- 
adjusted  dressing,  that  comes  forward  underneath  so  as 
to  include  the  frenum,tiie  simple  dorsal  slit  is  suflicient ; 
but  if  any  of  the  prepuce  depasses  the  dressing  under- 
neath, it  will  puff  and  become  (Edematous  and  require 
frequent  puncturing.  To  avoid  it,  it  is  better  to  make 
the  Cloquet  slit  at  once.  This  operation  is  of  no  value, 
and  perfectly  impracticable  in  a  thick,  pendulous  pre- 
puce. Absorption  will  often  remove  considerable  pre- 
putial tissue,  but  where  there  is  too  much  its  very  bulk 
interferes  with  its  removal  by  an}^  natural  means. 

Dilatation  is  recommended  by  a  number  of  surgeons, 
but,  I  must  admit,  in  my  hands  it  has  always  proved  a 
failure  ;  it  may  be,  that  if  the  subsequent  history  of  the 
cases  reported  as  so  operated  upon  had  been  carefully 
traced,  the  reports  would  not  have  been  so  good. 
iS^elaton,  whose  dilating  instrument  is  generally  recom- 
mended, seems,  himself,  to  prefer  some  of  the  circum- 
cising methods,  as  in  the  volume  on  ''  Diseases  of  the 
Geiiito-Urinary  Organs,"  in  his  "  Surgery,"  being  the 
sixth  volume  of  the  revised  edition  of  1884,  by  Despres, 
Gillettte,  and  Horteloup,  the  subject  of  dilatation  is  dis- 
missed in  two  short  lines.  St.  Germain,  of  Paris,  uses, 
as  has  been  before  observed,  a  two-bladed  forceps,  used 
after  the  manner  of  Nelaton,  and  reports  good  results. 
Dr.  J.  Lewis  Smith  agrees  in  his  statements  with  Dr. 
St.  Germain.  Dr.  Holgate,  of  New  York,  reports  a  like 
experience.  In  my  own  practice  the  prepuce  has  often 
been  made  temporarily  \siX.  and  retractable,  but  with  the 
usual  results  of  the  return  of  the  contraction,  with  a  pos- 
sible thickening  of  the  inner  fold,  as  a  result  of  the  inter- 
ference ;  so  that  only  in  case  of  any  immediate  demand, 


Surgical  Operations  Performed  on  the  Prepuce.     309 

where  the  tight  prepuce  is  producing  irritation,  either 
through  pressure  or  adhesions,  or  retained  sebaceous 
matter,  do  I  ever  resort  to  dilatation  ;  always,  however, 
even  then,  not  as  a  final  operation,  but  merely  as  pre- 
paratory procedure  toward  a  future  operation  of  a  more 
efficient  order. 

In  cases  of  timid  adults,  who  refuse  all  kinds  of 
operative  interference,  good  results  may  be  obtained  by 
the  use  of  a  mild  lead-wash  or  cold  tea-baths  and  the 
introduction  of  flat  laj^ers  of  dry  lint  interposed  between 
the  prepuce  and  the  glans  ;  this  has  a  very  good  effect 
in  keeping  the  parts  apart  and  dry,  and  may  in  time 
produce  a  certain  amount  of  dilatation  ;  but  even  when 
this  is  done,  unless  it  will  render  the  foreskin  sufficiently 
loose  to  allow  of  its  being  kept  finally  back  of  the  corona, 
it  is,  after  all,  but  a  temporary  makeshift.  The  corona 
should  be  exposed  and  kept  clear  of  the  preputial  cover- 
ing ;  anything  short  of  this  will  not  give  all  the  good  re- 
sults to  be  desired.  I  have  more  than  once  performed 
a  secondary  opera.tion  on  Jews,  who  had  been  imper- 
fectly circumcised  by  not  having  the  prepuce  removed 
sufficiently,  and  in  whom  the  subsequent  contraction 
of  the  preputial  orifice  had  re-covered  part  of  the  glans, 
and  only  lately  visited  a  four-year-old  boy,  circumcised 
when  eight  days  old,  in  whom  the  prepuce  covered 
half  of  the  glans,  the  corona  acting  as  a  tractive  point 
from  which  the  penile  integument  was  being  drawn  for- 
ward. In  this  case  the  simple  pierced-lint  Maltese  cross 
was  used,  with  an  adhesive  band  to  hold  the  tails  down 
behind  and  around  the  penis  just  back  of  the  corona. 

These  means,  although  not  circumcisioft  either  in  a 
surgical  or  in  the  Hebraic  religious  sense,  are,  nevei'the- 
iess,  sufficient  in  a  medical  sense  for  all  desired  purposes  ; 
provided,  however,  that  there  is  no  resulting  constric- 


310  History  of  Circumcision. 

tion,  or  a  mild  condition  of  paraphimosis,  back  of  the 
corona,  and  that  the  whole  of  the  glans  is  sufficiently  un- 
covered, and  that  no  abnormal  dog-ears  are  left  to  garnish 
each  side  of  the  penis  like  an  Elizabethan  frill  or  collar ; 
although  Agnew  holds  that,  in  slitting,  the  practice 
adopted  by  many  of  rounding  oflf  the  corners  is  mostly 
superfluous,  as  nature  will  do  so  itself  in  time. 

The  ordinary  way  of  performing  the  operation  by 
modern  surgeons  is  by  what  is  known  as  the  Bumstead 
circumcision.  It  was  not  an  invention  of  Bumstead, 
but  was  adopted  by  him  in  preference  to  all  others. 
The  requisites  are  a  sharp-pointed  bistoury,  blunt- 
pointed  scissors,  and  a  pair  of  Henry's  phimosis  forceps, 
with  fine  needles  and  fine  oculists'  suture  silk.  The 
penis  is  allowed  to  hang  naturallj''  and  the  position  of 
the  corona  glandis  marked  on  the  outer  skin  with  a 
pen  and  ink,  which  is  to  serve  as  a  guide  for  the  incision. 
The  prepuce  is  now  drawn  forward  until  this  line  is 
brought  in  front  of  the  glans  and  grasped  between 
the  blades  of  the  forceps.  The  prepuce  is  now  trans- 
fixed, and,  with  a  downward  cut,  that  portion  is  severed  ; 
the  knife's  edge  is  now  turned  upward  and  the  excision 
finished.  The  forceps  are  now  removed  and  the  integu- 
ment allowed  to  retract ;  with  the  scissors  the  inner 
mucous  fold  is  now  split  along  the  dorsum  and  trimmed 
oflT  so  as  to  leave  about  half  an  inch  in  front  of  the 
corona.  The  parts  are  then  brought  together  with  the 
continuous  suture  and  dressed  according  to  the  fancy 
of  the  surgeon.  Care  must  be  taken  not  to  bruise  the 
parts  with  the  forceps,  as,  in  such  cases,  sloughing  of  the 
sutured  edges  will  be  the  result  instead  of  union,  I 
have'  seen  this  accident  happen  more  than  once,  in  one 
case  being  followed  by  a  penitis  that  seriously  compli- 
cated matters. 


Surgical  Operations  Performed  on  the  Prepuce.     31 1 

It  has  been  in}^  practice  to  use  fine  silver-wire  and 
catgut  sutures  in  all  operations  on  the  prepuce ;  they 
excite  less  suppuration  as  well  as  less  irritation.  In 
case  of  need,  the  silver  can  be  left  in  longer,  and  they 
are  much  easier  of  removal  than  the  silk ;  besides,  they 
have  the  advantage  of  not  cutting.  In  the  after-treat- 
ment the  same  general  plan  can  be  followed  as  with  any 
amputated  stump,  except  that  it  must  not  be  forgotten 
that  at  the  end  of  this  organ  dwells  what  has  been 
termed  the  sixth  sense,  and  that  heat  and  moisture  are 
very  apt  to  awaken  the  dormant  energies  of  the  organ, 
even  after  it  has  undergone  cruel  mutilation,  and  even 
has  suffered  considerable  loss  of  blood  ;  for  that  reason 
it  is  best  always  to  avoid  wet  or  sloppy  dressing,  or  too 
much  ointment,  as  thej-  are  more  apt  to  cause  erection 
than  to  do  any  good.  Besides,  I  find  water  does  here, 
as  elsewhere,  interfere  with  the  deposited  plastic  matter, 
properly  organizing  into  cicatricial  tissue ;  so  that  I 
prefer  a  snug,  dry  dressing,  which  is  left  on  for  four  or 
five  daj^s  without  being  interfered  with,  and  light  cover- 
ing, plain  diet,  quiet,  with  fifteen  grains  each  of  bromide 
of  sodium  and  chloral  hydrate  at  bed-time  to  insure  rest 
and  freedom  from  annoying  erections.  Where  the  organ 
is  large  in  its  flaccid  state,  it  is  better  to  support  it  on 
a  small  oakum-stuffed  pillow,  made  for  the  purpose,  than 
to  let  it  hang  downward.  Should  the  stitches  give  way 
and  the  skin  tend  to  retract,  the  plan  proposed  on  a 
previous  page  can  be  followed  to  advantage.  In  uri- 
nating, care  must  be  taken  not  to  soil  the  dressings ; 
some  patients  are  very  careless  about  this  if  not  warned. 
The  penis  should  hang  nearly  perpendicular  while  in  the 
act,  and  all  dribbling  should  have  ceased  and  the  meatus 
and  underneath  be  mopped  dry  with  some  soft  cotton 
before  raising  the  organ ;  nothing  so  irritates  the  parts, 


312  History  of  Circumcision. 

retards  union,  or  is  more  offensive  than  a  urine-saturated 
dressing. 

Dr.  Hue,  of  Rouen,  uses  an  elastic  ligature,  which 
he  introduces  into  the  dorsal  aspect  of  the  prepuce  by 
means  of  a  curved  needle.  This  he  ties  in  front,  and  in 
three  or  four  days  it  cuts  its  way  through.  Although 
Hue  reports  a  large  number  so  operated  upon,  the  tedi- 
ousness  of  the  procedure  and  the  swelling  and  oedema, 
as  well  as  the  active  pain  that  must  necessarily  accom- 
pany the  operation,  will  hardly  recommend  the  ligature 
in  preference  to  the  incision  by  the  knife. 

Dr.  Bernheim,  the  surgeon  of  the  Israelitish  Consis- 
tory of  Paris,  has  operated  on  over  eleven  hundred  cir- 
cumcisions, besides  the  cases  of  phimosis  occurring  in  his 
general  practice.  His  opinion  of  the  procedure  of  M,  de 
Saint-Germain  by  dilatation  is  not  favorable.  He  has  em- 
ployed it  in  a  number  of  cases  of  phimosis,  at  the  time 
unfit  for  a  more  radical  operation.  He  has,  however, 
observed  that  cicatricial  thickenings  and  recontractions 
are  very  apt  to  occur,  and,  as  to  the  septic  accidents 
mentioned  in  connection  with  circumcision,  he  has  noted 
that  they  are  as  liable  to  occur  in  hands  that  are  as 
careless  and  slovenly  with  what  they  do  with  their 
dilating  forceps  as  they  are  with  what  they  do  with  their 
bistouries.  Dr.  Bernheim  prefers  the  circumcision  for- 
ceps of  Ricord,  as  modified  by  M.  Mathieu.  This 
instrument  he  prefers  by  reason  of  its  gentler  pressure, 
which,  at  the  same  time,  is  all-sufficient  to  properly  fix 
the  prepuce.  In  applying  the  forceps,  he  includes  as 
little  as  possible  of  the  lower  part,  keeping  away  as 
much  as  possible  from  the  frenic  artery.  The  dorsum 
of  the  inner  fold  he  cuts  with  the  scissors.  In  children 
under  two  years  of  age,  he  simply  turns  this  back  over 
the  free  edge  of  the  integument ;  in  children  over  two 


Surgical  Operations  Performed  on  the  Prepuce.     313 

years  of  age,  be  uses  serres-fines.  In  children,  he  uses 
a  piece  of  lint  .dressing  steeped  in  a  water}^  solution  of 
boracic  acid  ;  in  adults,  he  uses  iodoform-gauze  dress- 
ings. He  finds  cases  unite  in  from  three  to  ten  days. 
Dr.  Bernheim  warns  us  against  using  antiseptics  on 
infants  or  young  children,  in  connection  with  the  after- 
dressing  of  circumcision.  Neither  plienic  acid,  cor- 
rosive sublimate,  nor  iodoform  are  well  borne  by  these 
young  subjects,  and  he  has  seen  serious  results  follow 
upon  as  light  an  application  as  a^^g^  solution  of  phenic 
acid.  In  a  number  of  cases  he  reports  operating  with 
the  galvano-cautery  of  Chardin,  instead  of  the  knife. 
These  operations  were  bloodless,  and  cicatrization  was 
as  rapid  as  when  the  knife  was  used.  He  has  in  several 
cases  operated  by  the  dorsal  incision,  owing  to  disease 
of  the  prepuce  not  allowing  any  other  operation. 

In  France,  the  Bumstead  operation  is  known  under 
the  title  of  Ricord's  procedure.  Lisfranc,  Malapert,  M. 
Coster,  and  Yidal  all  have  operations  which  are  not  as 
useful  as  Ricord's,  and  have  not,  therefore,  come  into 
general  use.  M.  Sedillot  condemns  the  dorsal  incision 
as  leaving  two  unsightl}' -looking  flaps.  The  reverse,  or 
Inferior  incision  of  M.  Jules  Cloquet  is  likewise  not  in 
favor  with  either  Malgaigne  or  Ricord.  This  inferior 
incision  or  section,  alongside  of  the  frenum  was  first 
advised  by  Celsus.  M.  Cullerier  contented  himself  with 
slitting  the  inner  preputial  fold,  longitudinally,  from  its 
junction  with  the  skin  backward  to  the  corona.  M. 
Chauvin,  by  the  aid  of  a  complicated  instrument  with 
barbed  points,  drew  out  the  mucous  fold  as  far  as  pos- 
sible before  excising. 

There  is  something  unaccountable  in  the  difference 
in  results  that  various  operations  give  in  the  hands  of 
diflferent  surgeons.     It  must  be   that  all  methods  are 


314  History  of  Ci7'Cumcision. 

correct  with  properly-chosen  cases  and  when  properly 
performed,  as  well  as  properly  looked  after  subsequently 
to  the  operation.  It  must  not  be  expected,  however, 
that,  in  operations  where  the  kindl}-  assistance  of  nature 
is  a  thing  contemplated  in  absorbing  superfluous  tissue, 
the  case  will  at  once  give  satisfaction  to  all.  These 
cases  must  have  the  required  time  before  judgment  can 
be  passed  upon  the  merits  of  the  operation,  just  as 
required  time  in  cases  of  dilatation  or  in  the  method  of 
M.  Cullerier  will  often  demonstrate  that  the  benefits  are 
but  transient,  and  that  often  even  cases  that  have  been  so 
operated  upon  will  require  a  complete  circumcision,  a  la 
Ricord  or  a  la  Bumstead,  owing  to  the  resulting  thick- 
ening induration  and  overconstriction,  when,  if  left 
alone,  the  dorsal  slitting  or  the  inferior  incision  of 
Cloquet  would  have  previously  given  satisfactory 
results. 

The  final  cosmetic  results  in  the  combined  Cloquet 
and  dorsal-slit  operation,  for  instance,  depend  on,  first, 
properly  choosing  the  case.  One  on  whom  the  operation 
is  unadaptable  it  is  useless  to  attempt  it  on,  as  a  future 
circumcision  or  tedious  and  annoying  re-operation  of 
trimming  would  be  required.  The  next  care  is  to  prop- 
erly cut  through  all  constricting  bands,  wliicli,  like 
fine,  tough  strings,  will  be  found  to  encircle  the  penis. 
These  must  be  carefully  clipped  with  a  fine  pair  of 
strabismus  scissors,  as  these  bands  do  not  give  way, 
either  then  or  afterward,  of  their  own  accord,  but  form 
the  nucleus  for  stronger  constricting  bands  for  the 
future.  Then  3'Ou  must  be  sure  to  cut  far  enough  back, 
either  above  or  below,  until  j^ou  have  reached  where 
you  obtain  the  normal  and  largest  calibre  of  circumfer- 
ence of  the  penis.  The  adaptation  of  the  edges  of  th6 
parts  and  the  proper  application  of  a  smooth,  equal  press- 


Surgical  Operations  Performed  on  the  Prepuce.     315 

lire,  by  means  of  the  lint  strap,  is  of  the  next  impor- 
tance ;  and  then  comes  the  strapping  of  the  whole  surface 
for  about  an  inch  and  a  half  back  of  the  corona,  which 
should  and  must  include  all  the  tissues  of  the  preputial 
part  of  the  frenum.  A  neglect  or  careless  perform- 
ance of  any  of  the  details,  or  the  carelessness  of  the 
patient  in  not  keeping  the  dressing  clean,  necessitating 
its  change  before  the  fourth  day,  all  tend  not  only  to 
interrupt  the  union,  but  to  mar  the  future  cosmetic  re- 
sults as  well.  It  may  be  asked  why  all  this  care  and 
trouble,  and  not  circumcise  at  once  ?  As  already  ob- 
served, this  operation  admits  of  the  patient  following 
his  business  ;  whereas  circumcision,  on  the  male,  will 
assuredly  lay  him  up  for  four  or  five  days,  and  perhaps 
ten  days, — something  that  many,  be  they  rich  or  poor, 
cannot  afford,  and  will  not  submit  to. 

The  cosmetic  condition  of  the  penis  as  a  copulating 
organ  is  a  thing  of  some  importance,  and  this  should 
not  be  overlooked  ;  for,  although  the  particular  dimen- 
sion, shape,  or  peculiarity  of  the  penile  end  never  figures 
prominently  in  the  complaints  of  women  who  apply  for 
divorce, — the  charges  being  everything  else  under  the 
sun, — it  can  safely  be  assumed  that  this  organ  and  its 
condition  is  the  original,  silent  and  unseen,  as  well  as  un- 
conscious power  behind  the  throne  that  is  at  the  bottom 
of  the  whole  business  in  more  than  one  case.  Like  the 
fable  of  the  poor  lamb  that  the  wolf  wished  to  devour: 
the  real  reason  of  his  wishing  to  kill  him  was  that  he 
might  eat  him,  the  pretext  set  "forth  by  the  wolf  that  the 
lamb  had  encroached  on  his  pasture,  muddied  his  brook, 
or  kept  him  awake  by  his  bleating  having  been  dis- 
proven  by  the  lamb.  Besides,  it  is  well  not  to  leave 
any  distinctive  or  distinguishing  mark,  like  an  indi- 
vidual baronial  crest,  on  the  head  of  the  organ. 


316  History  of  Circumcision. 

To  return,  however,  to  the  operative  procedures,  we 
find  that  Dr.  Yanier  finds  that  the  operation  of  Cloquet 
by  incision  alongside  of  the  freniim  has  the  advantage 
of  not  leaving  an}^  deformity — contrary  to  tbe  opinion 
of  Ricord  and  Malgaigne.  He,  in  fact,  holds  this  pro- 
cedure in  such  high  esteem  that  he  considers  that  Clo- 
quet deserves  great  credit  for  reviving  this  old  Celsian 
operation.  H.  H.  Smith,  in  his  "  Operative  Surgery," 
coincides  with  Yanier  in  his  favorable  opinion  of  this 
method,  as  he  there  saj'S  :  "  Frequent  opportunities  of 
testing  the  advantages  of  the  plan  of  Cloquet  having 
satisfied  me  of  its  value,  I  do  not  hesitate  to  recommend  it 
as  that  best  adapted  to  the  adult,  because  it  fuU}^  exposes 
the  glans  and  leaves  little  or  no  lateral  deformit}',  as  is 
frequently  the  case  with  the  dorsal  incision," — an  opin- 
ion that  I  can  fully  agree  with,  from  the  results  of  the 
same  operation  in  my  liands,  although  I  have  used  the 
method  even  on  infants.  Yanier  does  not  approve  of 
the  dorsal  incision  unless  it  is  made  V-shai3ed,  as  it 
otherwise  leaves  the  unsightly  lateral  flaps,  but  thinks 
well  of  the  modification  of  Cloquet's  practiced  by  M. 
Yidal  de  Cassis,  which  is  performed  in  the  following 
manner :  The  patient  stands  before  the  operator,  who 
remains  sitting ;  the  operator  seizes  the  prepuce  on  its 
dorsum  and  draws  it  toward  him  ;  he  then  introduces  a 
narrow,  sharp-pointed  bistoury,  with  its  point  armed 
with  a  small  waxen  bullet,  down  alongside  of  the 
frenum  until  he  reaches  the  pouched  extremity  of  the 
preputial  cavity  at  this  point ;  the  point  of  the  bistoury 
is  now  made  to  transfix  the  waxen  bullet  and  out 
through  the  skin,  which  from  this  point  is  divided  from 
behind  forward.  Yanier  very  sensibly  suggests  that  the 
operation  that  is  effectual,  and  wliich  can  be  accom- 
plished in  the  least  number  of  movements  or  temps,  as 


Surgical  Operations  Performed  on  the  Prepuce.     317 

being  the  least  likely  to  cause  extensive  pain  and  agon}-, 
should  be  the  one  preferred,  and  that  the  aim  of  the 
surgeon  should  be  to  simplify  the  operation  hy  reducing 
the  number  of  necessary  movements.  For  this  reason, 
where  an  excision  of  considerable  amount  of  tissue  is 
required  by  the  nature  of  the  case,  he  prefers  another 
operation,  performed  by  Lallemand, — that  of  making  a 
dorsal  transfixion  and  cutting  off  the  two  lateral  flaps, 
which  can  all  be  done  in  three  movements. 

It  makes  but  little  difference  as  to  which  operation 
is  performed  on  the  adult,  but  that  the  subsequent 
dressing  will  exercise  a  good  or  evil  influence,  and 
greatly  assist  not  only  in  the  present  comfort  or  dis- 
comfort of  the  patient,  but  in  the  ultimate  result  as 
well.  Bearing  these  points  in  view,  Charles  A.  Ballance, 
of  St.  Thomas's  Hospital,  has  adopted  the  following 
procedure  : — 

"When  the  patient  is  etherized,  the  outline  of  the 
posterior  border  of  the  glans  is  marked  on  the  skin 
with  an  aniline  pencil.  The  skin  of  the  prepuce  is  slit 
and  removed  up  to  the  aniline  line.  The  mucous  mem- 
brane is  next  cut  away,  leaving  only  a  free  edge  of  about 
one-eighth  of  an  inch  in  width.  Any  bleeding  which- 
occurs  should  be  entirely  arrested,  and  asepsis  must  be 
insured  by  frequent  sponging  with  carbolic  or  sublimate 
solution.  Numerous  coarse-hair  stitches  are  then  in- 
serted;,  so  as  to  bring  accurately  together  the  fresh-cut 
edges  of  the  skin  and  mucous  membrane,  and  subse- 
quently, after  a  further  sponging  and  dr3'ing,  a  piece  \)f 
gauze  two  laj'ers  of  thickness,  and  wide  enough  to  reach 
from  the  root  of  the  penis  nearly  to  the  meatus,  is 
wrapped  loosely  around  the  penis  and  secured  by  several 
applications  of  the  collodion-brush.  The  setting  of  the 
collodion  is  hastened  by  the  use  of  a  fan,  so  that  the  air 


318  History  of  Circumcision. 

is  kept  in  motion,  and  the  patient  should  not  be  allowed 
to  recover  from  the  ansesthetic  until  the  dressing  is  quite 
firm  and  hard.  This  dressing  forms  a  carapace  for  tiie 
penis,  protecting  it  from  the  bedclothes  and  effectually 
preventing  the  anno3'ing  and  distressing  erections.  Mr. 
Ballance  reports  excellent  results  from  this  dressing." 
(Braithwaite's  Retrospect^  J"ly,  1888.) 

In  applying  the  above  dressing,  the  shrinking  inci- 
dent to  the  drying  of  the  collodion  must  not  be  over- 
looked, and  the  gauze  layers  must  be  loosely  applied,  as 
they  would  otherwise  become  too  tight.  The  dressing 
is  a  very  ingenious  and  serviceable  one. 

Mr.  A.  Gr.  Miller,  at  a  meeting  of  the  Edinburgh 
Medico-Chirurgical  Society,  reported  a  new  method  of 
dressing  after  circumcision.  "  It  consisted  in  first  closely 
suturing  the  skin  and  mucous  membrane  by  numerous 
catgut  sutures,  then  painting  the  surface  with  Friar's 
balsam  and  covering  it  over  with  two  or  three  layers 
of  cotton  wadding,  on  which  the  balsam  is  poured.  The 
glans  penis  was  left  sufficiently  free  to  allow  of  water 
passing.  The  band  or  ring  of  dressing  should  be  at 
least  one  inch  broad.  The  dressing  was  not  suitable 
for  young  infants  who  were  frequently  wetting.  In  the 
case  of  older  children,  they  might  be  allowed  to  go 
about  on  the  second  or  third  day,  when  the  dressing 
would  be  quite  dry,  and  would  not  be  I'equired  to  be 
changed  or  renewed."  (Braithwaite's  i?e<rospecf,  Januar}^, 
1888.) 

Any  constricting  or  immovable  and  inelastic  dress- 
ing is  subject  to  the  same  objections  as  plaster-of-Paris 
dressings  in  thigh-fractures, — that  of  being  dangerous 
and  not  expedient,  unless  the  patient  is  constantly 
under  your  eye. 

Dr.  Neil  Macleod,  in  the  Edinburgh,  Medical  Journal 


Surgical  Operations  Performed  on  the  Prepuce.     319 

for  March,  1883,  advises  a  procedure  that  has  alwa3's 
looked  favorably  to  me,  and  which  I  once  put  in  prac- 
tice through  the  means  of  the  ordinar_y  ptosis  fenes- 
trated forceps,  in  place  of  the  ordinary  circumcision 
forceps,  the  sutures  being  introduced  through  the  fenes- 
tra and  the  prepuce  cut  off  on  the  outer  side  of  the 
forceps,  the  thickngss  of  the  steel  arm  on  the  outer  side 
of  the  fenestra  allowing  of  the  properly-sized  border 
for  the  hold  of  the  sutures.  Dr.  Macleod  places  his 
sutures  all  in  position  before  making  any  incisions, — a 
procedure  which  will  be  found  to  save  the  patient  con- 
siderable pain ;  as  with  many  the  seizing  and  holding  of 
the  edges  of  the  skin  and  mucous  membrane  and  the 
forcible  pressure  exerted  by  the  fingers  or  forceps  while 
the  needle  is  being  forced  through  is  the  most  pain- 
ful part  of  the  operation.  In  doing  this,  care  must 
be  taken  to  allow  sufficient  length  to  each  thread  to 
make  two  sutures,  as  well  as  care  must  be  taken  to 
properl}'  pull  out  the  thread  in  the  centre  between  the 
four  folds  of  tissue  and  to  cut  it  equidistant,  after  the 
ablation  of  the  prepuce,  a  blunt  hook  being  used  to  fish 
up  the  threads  from  the  preputial  opening. 

Erichsen  favors  the  Jewish  operation  in  young  chil- 
dren, as  being  the  easiest  and  safest  of  performance. 
Slitting,  or  the  inferior  or  superior  incision,  he  thought, 
left  too  much  of  the  prepuce,  which,  wherever  there  is  a 
tendency  to  phimosis,  should  be  entirely  removed,  "  with 
a  view  of  preserving  the  health  and  cleanliness  of  the 
parts  in  after  life."  In  the  phimosis  that  is  acquired  by 
old  men,  he  found  dilatation  with  a  two-bladed  instru- 
ment to  be  sufficient,  provided  the  indurated  circle  was 
made  to  yield.  For  the  circumcision  of  adults  he  has 
invented  an  adjustable  shield,  something  like  the  Jewish 
spatula,  with  which  he  protects  the  glans. 


320  History  of  Circumcision. 

Gross  (the  elder)  used  both  slitting  on  the  dorsum 
and  circumcision.  He  found  neither  objection  nor 
deformity  in  the  flaps  left  by  the  dorsal  incision,  as 
thej'  were  only  temporarj^ ;  in  some  cases,  he  simply  fol- 
lowed the  practice  of  Cullerier,  of  making  multiple  slits 
in  the  constricting  and  inelastic  mucous  membrane. 

Agnew  believes  in  circumcision  in  the  treatment  of 
reflex  troubles.  He  relates  a  case,  in  the  second  volume 
of  his  "  Surger}^,"  of  eczema  extending  over  the  abdo- 
men, of  over  a  year's  standing,  cured  in  a  child  by  cir- 
cumcision ;  he  operates  by  incision  on  the  dorsum,  in 
which  he  leaves  nature  to  make  away  with  the  flaps,  or 
he  circumcises  by  the  Bumstead  method. 

Yan  Buren  and  Ke3res  recommend  both  the  incision 
on  the  dorsum  and  the  operation  of  Ricord  ;  where  the 
mucous  membrane  alone  is  tight  and  constricted,  they 
follow  Cullerier's  method  of  either  single  or  multiple 
incisions  of  the  inner  coat.  They  Lny  great  stress  on 
the  necessity  of  keeping  the  patient  quietly  in  bed. to 
insure  rapid  and  complete  union. 

My  friend,  Dr.  Robert  J.  Gregg,  of  San  Diego,  has 
lately  operated  on  a  number  of  cases,  the  operation 
being  perfectly  painless,  the  little  patients  submitting 
to  it  and  feeling  no  more  pain  than  if  it  were  having  its 
toe-nails  trimmed,  the  local  anjesthesia  being  produced 
by  the  hj-podermatic  injection  of  cocaine.  This  pro- 
cedure is  now  used  to  a  considerable  extent  throughout 
the  country,  and  it  is  a  far  safer  and  more  comfortable 
performance  than  either  etherizing  or  cliloroforming,  as 
the  sudden  and  spasmodic  filling  of  the  lungs  of  young 
children — who  will  resist  and  hold  their  breath  for  a 
long  time,  then  suddenly  inhale — with  aufesthetie  vapor 
is  almost  unavoidable,  having  in  two  instances  nearly 
lost  two  children  from  such  an  accident. 


Surgical  Operations  Performed  on  the  Prepuce.     321 

Dr.  Gr.  W.  Overall,  in  a  late  Medical  Record^  wbicli 
is  quoted  in  the  Journal  of  the  American  Medical  Asso- 
ciation of  February  21,  1891,  gives  the  description  of  a 
very  good  and  painless  method  of  producing  this  local 
anaesthesia;  for  it  need  hardly  be  said  tliat  with  a 
nervous,  irritable  child  the  introduction  of  the  h3'poder- 
matic  needle  is  as  formidable  an  operation  as  either 
slitting  or  the  Jewish  operation.  Dr.  Overall  is  in  the 
habit  of  holding  a  solution  within  the  preputial  cavity 
and  then  to  introduce  the  needle  in  the  mucous  fold, 
having  previously  applied  a  light  rubber  band  back  of 
the  corona,  on  the  outer  integument,  so  as  to  act  like  a 
tourniquet  and  limit  the  action  of  the  anaesthetic  effect 
to  the  prepuce.  By  this  procedure  he  avoids  all  pain 
and  the  operation  can  be  performed  while  the  child  is 
even  amusing  itself,  care  being  taken  that  it  does  not 
see  it.  Sutures  that  require  removal  should  not  be 
used,  according  to  the  Doctor,  and  the  operation  thereby 
becomes  a  perfectl}''  painless  and  unalarming  perform- 
ance to  the  patient  in  all  its  details.  ^ 


NOTES  TO  TEXT. 


1.  "  Letters  of  Certain  Jews  to  Monsieur  Voltaire,  Containing  an  Apology 

for  their  own  People."  Pages  451-476.  Translated  by  Dr.  Lefann. 
Philadelphia,  1848. 

2.  "CirconcisionchezlesEgyptiens."  Brochure  by  F.  Chabas.  Paris,  1861. 

3.  "Atlantis."    By  Ignatius  Donnelly.    P£tge  472. 

4.  Ibid.,  page  115. 

5.  Ibid.,  page  234. 

6.  Ibid.,  page  178. 

7.  "Circumcision."  A.  B.  Arnold.  New  York  Med.  Record,  Feb.  13,  1886. 

8.  "Atlantis,"  page  178. 

9.  This  word  is,  in  the  Mandan,  Maho-peneta  ;  in  the  Welsh,  Mawr- 

pencethir.     "Atlantis,"  page  115. 

10.  "Cyclopedia  of  Biblical,  Theological,  and  Ecclesiastical  Literature," 

vol.  viii.  page  58.    Article,  Phallus. 

11.  "Origine,  Signification  et  Histoire,  de  la  Castration,  de  I'eunuchism,  et 

la  circoncision."  Par.  F.  Bergmann.  Published  in  the  "  Archivio  per 
le  Tralditione  Populaire,"  1883. 

12.  "  Dictionaire  des  Sciences  Medicales."  Par  une  Societe  de  medecins  et 

de  Chirurgiens.    Paris,  1826,  60-volume  edition. 

13.  Dr.  Delange  mentions  a  peculiar  social  habit  or  custom  among  a  tribe 

of  Arabians  that  in  a  sociological  sense  is  worth  mentioning.  He 
observes  that  for  these  dances  females  are  preferred,  but  owing  to 
the  peculiar  habit  about  to  be  related  it  is  impossible  to  have  any  of 
the  village  women  in  Algeria  assist  at  this  part  of  the  festivities  ; 
hence  the  men  have  to  do  the  dancing.  It  appears  that  the  females 
of  one  tribe— this  being  the  tribe  of  Ouleds-Nails,  who  live  on  the 
southern  borders  of  Algiers— are  in  the  habit,  when  young,  of  emi- 
grating to  the  oases  of  the  Sahara,  which  are  occupied  by  the  French 
and  traveling  Arabs,  where  they  give  themselves  up  to  a  life  of 
prostitution.  After  having  exercised  this  life  for  some  years  they 
return  to  the  tribe  with  a  dowry  in  money,  besides  an  ample  supply 
of  clothes  and  jewelry,— the  result  of  their  economy,— which  enables 
them  to  contract  favorable  marriages.  This  practice  is  so  common 
in  this  one  particular  ti-ibe,  and  so  much  have  they  monopolized  the 
profession  of  courtesan,  that  the  name  of  the  tribe  of  Ouleds-Nails  is 
in  Arabia  synonymous  with  that  of  courtesan.  These  young  women 
dance  every  evening  in  the  Arab  cafes,  and  are  At  times  employed 
to  do  the  dancing  at  Arab  feasts.  For  this  reason  no  self-respecting 
Arab  woman  ever  allows  herself,  to  dance  in  public,  or  why  the 
practice  of  both  sexes  dancing  together  is  not  practiced  in  Algerian 
villages,  as  a  man  would  thereby  consider  himself  disgraced. — Dr. 
Delange,  in  Receuil  de  Memrdres  de  Medecine  de  Chirurgie  et  de 
Pharmade  Militaire,  No.  105,  August,  1868. 

(323) 


324  Notes  to  Text. 

14.  "Tractatus,  Albert!  Bobovii,  Turcarum  Imp.  Moliammedis  IV  olim 

Interpretis  piimarii,  De  Turcarum  Liturgia,  peregrinationeMeccana, 
Circumcisione,  ^grotorum  Visitatione,"  etc.    Oxonii,  1690. 

15.  Michel  L.e  Feber.     "  Le  Theatre  de  la  Turquie."    Paris,  1681. 

16.  "La  Circoncisiou,  Sa  Si giiiti cation  Social  et  Religieuse."   Par  M.  Paul 

Lafargue,  in  the  Bulletins  de  la  Societe  d' Anlhropologie  de  Paris. 
Tome  X,  3d  fascicule,  Juin  a  Octobre,  1887. 

17.  "Circumcision."  By  A.  B.  Arnold.  NewYork  Med.Record,¥e\y.\i,V^. 

18.  Bancroft's  "  Native  Races,"  vol.  ii,  page  278. 

19.  "  Recherches  Philosophiques  sur  les  Americains,  ou  Memoires  Inter- 

essants  pour  servir  a  I'Histoire  de  I'Espece  Humaine."  Par  M. 
de  P.  Edition  par  Dom  Pernety.  Tome  ii.  Article,  Circoncision. 
Berlin,  1774. 

20.  "  The  Family,  a  Historical  and  Social  Study."    By  Charles  Franklin 

Thwing.    Boston,  1887. 

21.  The  "Recherches  Philosophiques  sur  les  Americains"  and  Virey,  in  the 

24th  volume  of  the  "Dictionaire  des  Sciences  Medicales,"  are  very 
full  on  this  subject,  and  for  fuller  information  the  reader  is  referred 
to  those  works. 

22.  "  Cause  Morale  de  la  Circoncision  des  Israelites,  Institution  Prevent- 

ive de  rOnanisme  des  Enfants."  Par  le  Docteur  Vanier,  du  Havre. 
Paris,  1847. 

23.  "Annual  Report  of  the  Bureau  of  Ethnology."    By  J.  "W.  Powell. 

Washington,  1881,  1882. 

24.  "Among  Cannibals,  or  Four  Years'  Travels  in  Australia."     By  Carl 

Lumholtz.    Page  46.    Charles  Scribner  &  Son,  1889. 

25.  These  interesting  historical  facts  in  relation  to  the  holy  prepuce  were 

published  in  the  Journal  V Exconimunier  in  January  of  1870,  when 
the  writer  was  in  France.  They  were  contributed  by  A.  S.  Morin, 
of  Miron,  a  learned  historiographer  and  antiquary.  Europe  has  not 
recovered  from  its  love  of  the  supernatural  tliat  it  had  so  strongly 
in  the  middle  ages.  The  blood  of  St.  Gennaro  still  liquefies  once  a 
year,  and  many  churches  still  claim  to  possess  the  identical  winding 
slieet  that  served  our  Lord  prior  to  his  resurrection,  as  well  as  more 
than  one  church  has  the  holy  cloth  that  St.  Veronica  used  on  the 
way  to  Calvary,  which  has  an  impression  of  the  face  of  the  Saviour. 

26.  This  church  has  a  remarkable  history  connected  with  its  foundation. 

The  tradition  relates  that  in  the  dark  ages  some  sacrilegious  soldier 
had  robbed  a  church  in  the  neighborhood  of  its  holy  vessels  of  gold 
and  silver.  In  the  vessel  in  the  Tabernacle  there  happened  to  be  a 
consecrated  wafer.  The  soldier  journeyed  on  to  Turin  to  dispose 
of  his  plunder,  when,  on  arriving  at  the  spot  on  which  the  church 
now  stands,  the  wafer  is  said  to  have  ascended  miraculously  to  some 
distance  above  the  soldier's  head,  while  at  the  same  time  the  mule 
he  rode,  being  imbued  with  more  religious  piety  than  his  master 
reverently  knelt  down  on  his  front  legs.  The  holy  wafer  was  now 
encircled  by  a  halo  of  shining  light ;  this,  with  the  kneeling  donkey 
and  the  soldier  raining  blows  on  the  pious  animal,  while  he  himself 
was  unconscious  of  the  presence  of  the  host  above  him,  attracted 
the  attention  of  the  populace,  who  apprehended  the  soldier,  on 
whom  the  stolen  vessels  were  found.  The  bishop  in  his  pontiflcial 
robes,  in  solemn  procession,  received  the  consecrated  wafer,  which 
promptly  descended  into  pious  hands.    The  donkey  was  adopted  by 


Notes  to  Text.  325 

the  bishop  and  the  soldier  was  promptly  hanged,  in  accordance  with 
the  general  treatment  of  thieves  in  those  days.  The  writer  has  more 
than  once  seen  a  flagstone  inclosed  within  a  railing  that  occupies 
the  central  spot  of  the  floor  or  pavement  of  the  church,  it  being  the 
identical  spot  on  which  the  donkey  knelt. 

27.  Rush's  "  Medical  Inquiries,"  vol.  i,  page  217. 

28.  Fothergill.     "  Gout  in  its  Protean  Aspects,"  page  158. 

29.  "Philosophy  of  Magic,"  from  the  French  of  Eusebe  Salverte,  vol.  ii, 

page  143. 

30.  "  Dictionaire  des  Sciences  Medicales."    Cullerier.    Article,  Phimosis. 

Vol.  xli. 

31.  Bergmann  has  gone  into  this  subject  at  length,  and  the  writer  has 

drawn  freely  from  his  brochure  on  "Castration  and  Eunuchism," 
reprinted  from  the  "  Archivio  per  le  Traditione  Populaire"  of  1883. 

32.  "The  Hermit."    By  the  Rev.  Cliarles  Kingsley.    See  Introduction. 

33.  "Dictionaire  des  Sciences  Me'dicales,"  vol.  li  v,  page  570. 

34.  Ibid.,  page  567. 

35.  Ibid.,  page  570. 

36.  "Cyclopedia  of  Biblical,  Theological,  and  Ecclesiastical  Literature," 

Vol.  iii,  page  351. 

37.  Smollett  gives  a  good  account  of  the  Carthagena  expedition  in  his 

"Roderick  Random,"  and  for  a  good  satisfactory  detail  of  the 
blundering  Walcheren  expedition  the  reader  is  referred  to  Harriet 
Martineau's  "History  of  England,"  vol.  i,  pages  269,  272,  273,  and  354. 

38.  Schoopanism,  or  paederastia,  is  at  times  practiced  by  the  Omahas,  and 

the  man  or  boy  who  suffers  as  the  passive  agent  is  called  min-qnga, 
or  hermaphrodite.— "Third  Annual  Roport  of  the  Bureau  of  Eth- 
nology."   By  J.  W.  Powell.    Washington,  1881,  1882. 

39.  "When  the  missionai-ies  first  arrived  in  this  region  they  found  men 

dressed  as  women  and  performing  women's  duties  who  were  kept 
for  unnatural  purposes.  From  their  youth  up  they  were  treated, 
instructed,  and  used  as  females,  and  were  even  frequently  publicly 
married  to  the  chiefs  or  great  men. — Bancroft's  works,  vol.  i, 
"Native  Races,"  page  415. 

40.  "  Recherches  Philosophiques  sur  les  Americains,"  tome  ii. 

41.  "The  History  of  the  Hebrew  Commonwealth."   From  the  German  of 

John  Jahn,  D.D.    Page  25.    Oxford,  1840. 

42.  "  L'Hermapbrodite  devant  le  Code  Civil."     Par  le  Docteur  Charles 

Debierre.    Bailliere  et  Fils.    Paris,  1886. 

43.  "Recherches  Philosophiques  sur  les  Americains,"  tome  ii,  page  78. 

44.  "  L'Hermapbrodite  devant  le  Code  Civil."     Debierre. 

45.  Occidental  Medical  Times,  Sacramento,  Cal.,  October,  1890,  page  543. 

46.  "Dictionaire  des  Sciences  Medicales,"  vol.  xxxi,  page  41. 

47.  British  and  Foreign  Medico-Chirurgical  Review,  vol.  xviii,  1856. 

48.  "  L'Hermaphrodite  devant  le  Code  Civil."    Debierre. 

49.  Sir  Thomas  Brown's  works,  vol.  ii,  "  Religio  Medici." 

50.  "  The  Bible  and  other  Ancient  Literature  in  the  Nineteenth  Century." 

L.  T.  Townsend,  D.D.    Chautauqua  press,  1889.    See  pages  32-45. 

51.  "The  Religions  of  the  Ancient  World."    George  Rawlinson,  M.A. 

Alden  edition  of  1885.    Page  174. 

52.  "The  Intellectual  Development  of  Europe."    John  W.  Draper.    Vol, 

ii,  page  113. 

53.  Ibid.,  vol.  ii,  page  122. 


326  Notes  to  Text. 

54.  In  "Clarke's  Commentary,"  vol.  i,  page  113,  the  reason  of  choosing 

the  eighth  day  is  given.  Circumcision  was  not  only  a  covenant,  but 
an  ottering  to  God ;  and  all  born,  whether  human  or  animal,  were 
considered  unclean  previous  to  the  eighth  day.  Neither  calf,  lamb, 
or  kid  was  offered  to  God  until  it  was  eight  days  old. — Lev.,  xxii,  27. 

55.  A  father  circumcised  his  children  and  the  master  his  slaves.    In  case 

of  neglect  the  operation  was  performed  by  the  magistrate.  If  its 
neglect  was  unknown  to  the  magistrate,  then  it  became  the  duty  of 
the  Hebrew,  upon  arriving  of  age,  to  either  do  it  himself  or  have  it 
done. — "Clarke's  Commentary,"  vol.  i,  page  113. 

56.  Bishop  Newton  points  out  the  remarkable  analogy  that  marks  the 

Hebrew  race  as  descendants  of  Isaac  and  the  Arab  race  as  the  de- 
scendants of  Ishmael,  from  whom  sprung  the  Saracenic  people. 
These  are  the  only  two  races  that  have  gone  on  in  their  purity  from 
their  beginning.  They  intermarry  only  among  themselves  and  have, 
alike,  the  same  customs  and  habits  as  their  fathers.  The  sculptured 
faces  of  the  Hebrew  on  the  Babylonian  monuments  are  the  same 
faces  that  are  met  in  the  synagogues  of  Paris  or  New  York.  So 
with  the  descendants  of  Ishmael,  in  whom  there  flows  partly  the 
blood  of  the  dominant  element  of  ancient  Egypt ;  neither  custom, 
habit,  nor  physiognomy  have  changed.  In  these  two  races,  as  ob- 
served by  Bishop  Newton,  we  have  an  ocular  demonstration  of  the 
Divine  origin  of  our  faith,  if  verification  of  Scripture  history  is  any 
criterion. — "Clarke's  Commentary,"  vol.  i,  page  114;  also,  Hosmer's 
"  Story  of  the  Jews,"  page  5. 

57.  "  Cause  Morale  de  la  Circoncision."    Vanier,  du  Havre.    Pages  40-45. 

58.  "  De  la  Circoncision."     Par  le  Dr.  S.  Bernheim.    Page  7.    Paris,  1889. 

59.  "Cyclopedia  of  Biblical,  Theological,  and  Ecclesiastical  Literature," 

vol.  ii,  page  350. 

60.  Among  the  Semitic  race,  however,  it  seems  possible  to  bring  forward 

better  evidence  than  this  of  an  early  Stone  Age.  If  we  follow  one 
way  of  translating  we  find,  in  two  passages  of  the  Old  Testament, 
an  account  of  the  use  of  sharp  stones  or  stone  knives  for  circum- 
cision,— Exodus,  iv,  25:  "And  Zipporah  took  a  stone";  and  Joshua, 
V,  2:  "At  that  time  Jehovah  said  to  Joshua.  Make  thee  knives  of 
stone."  ....  The  Septuagint  altogether  favors  the  opinion  that 
the  knives  in  question  were  of  stone,  by  reading,  in  the  first  place,  a 
stone  or  pebble,  and,  in  the  second,  stone  knives  of  sharp-cut  stone. 
These  are  mentioned  again  in  the  remarkable  passage  which  follows 
the  account  of  the  death  and  burial  of  Joshua  (Joshua,  xxiv,  29,  30), 
— "And  it  came  to  pass,  after  these  things,  that  Joshua,  the  son  of 
Nun,  the  servant  of  Jehovah,  died,  being  a  hundred  and  ten  years 
old,  and  they  buried  liim  in  the- border  of  his  inheritance  in  Tiranath 
Serah,  which  is  in  Mount  Ephraim,  on  the  north  side  of  the  hill  of 
Gaash."  Here  follows,  in  the  LXX,  a  passage  not  in  the  Hebrew 
text,  which  has  come  down  to  us  :  "  And  there  they  laid  with  him  in 
the  tomb,  wherein  they  buried  him  there,  the  stone  knives  where- 
with he  circumcised  the  children  of  Israel  at  the  Gilgals,  when  he 
led  them  out  of  Egypt,  as  the  Lord  commanded.  And  they  are  there 
unto  this  day."  The  rabbinical  law,  in  connection  with  this  subject, 
reads  as  follows  :  "  We  may  circumcise  with  anything,  even  with  a 
flint,  with  crystal  (glass),  or  with  anything  that  cuts,  except  with 
the  sharp  edge  of  a  reed,  because  enchanters  made  use  of  that,  or  it 


Notes  to  Text.  327 

may  bring  on  a  disease  ;  and  it  is  a  precept  of  the  wise  men  to  cir- 
cumcise with  iron,  whether  in  tlie  form  of  a  knife  or  scissors,  but  it 
is  customary  to  use  a  knife."  This  mention  of  the  objectionable  na- 
ture of  the  reed  as  a  circumcising  medium  is  attributed  to  the  dan- 
ger that  may  arise  from  splinters.  The  Fiji  Islanders  use  both  a 
rattan  knife  and  a  sharp  splinter  of  bamboo  in  performing  circum- 
cision and  in  cutting  the  umbilical  cord  at  child-birth.  Herodotus 
mentions  the  use  of  stone  knives  by  the  Egyptian  embalmers.  Stone 
knives  were  supposed  to  produce  less  inflammation  than  those  of 
bronze  or  iron,  and  it  was  for  this  reason  that  the  Cybelian  priests 
operated  upon  themselves  with  a  sherd  of  Samian  ware  (Samia 
testa),  as  thus  avoiding  danger.  There  seems,  on  the  whole,  to  be  a 
fair  case  for  believing  that  among  the  Israelites,  as  in  Arabia,  Ethi- 
opia, and  Egypt,  a  ceremonial  use  of  stone  instruments  long  sur- 
vived the  general  adoption  of  metal,  and  that  such  observances  are 
to  be  interpreted  as  relics  of  an  earlier  Stone  Age. — "Researches 
into  the  Early  History  of  Mankind."  By  Edward  B.  Tylor.  Pages 
217-220.    London,  1870. 

61.  The  cannibals  of  Australia  do  not  eat  white  people,  as  the  flesh  of 

these  produces  a  nausea,  which  the  flesh  of  the  vegetable-fed  blacks 
does  not  do.  The  rice-fed  Chinese  arc  considered  a  treat,  and  these 
are  slaughtered  in  great  number,  ten  Chinamen  having  been  served 
up  at  one  dinner. — "Among  Cannibals."  By  Carl  Lumholtz.  Page 
273. 

62.  "Cause  Moral  de  la  Circoncision."    Par  le  Dr.  Vanier.    Page  266. 

63.  Ibid.,  page  288. 

64.  Cincinnati  Clinic,  vol.  ii,  page  165. 

65.  "The  Story  of  the  Jews."    Hosmer.    Page  263. 

66.  "Traite  d' Hygiene,  publique  et  privee."    Michel  Levy.    2d.  edition, 

vol.  ii,  page  754. 

67.  Ibid. 

68.  "Diseases  of  Modem  Life."    B.  W.  Richardson.    Page  19. 

69.  "Longevity  and  other  Biostatic  Peculiarities  of  the  Jewish  Race." 

By  John  Stockton  Hough,  M.D.    New  York  Med.  Record,  1873. 

70.  "Vital  Statistics  of   the  Jews."     By  Dr.  John  S.   Billings.     North, 

American  Review,  No.  1,  vol.  152,  page  70,  January,  1891. 

71.  "  On  Regimen  and  Longevity."    By  John  Bell,  M.D.    Page  13. 

72.  British  and  Foreign  Medico-Chirurgical  Review,  vol.  xliii,  page  539. 

73.  Ibid.,  vol.  xlii,  page  17. 

74.  In  "Influence  of  the  Trades  on  Health,"  Thakrah  mentions  the  pecu- 

liar exemption  enjoyed  in  this  regard  by  the  butcher  class.  He 
quotes  Tweedie  in  saying  that  he  never  saw  a  butcher  admitted  to 
the  fever  hospital. 

75.  Lancereaux.    "  Distribution  de  la  Phthisic  Pulmonaire." 

76.  Ashhurst.     "Int.  Enc.  Surgery." 

77.  Horner.    "  Naval  Practice." 

78.  Cincinnati  Lancet  and  Observer.,  vol.  xvi,  1873. 

79.  It  may  well  be  a  question  of  some  interest  whether  the  atrophy  of  the 

testicle  in  the  aged  may  not  at  times  be  partly  due  to  the  compres- 
sion exercised  by  the  prepuce  on  the  glans  through  reflex  action, 
and  whether  at  times  the  virility  that  is  departing  cannot  be  restored 
by  circumcision  in  such  cases.  I  have  seen  such  results,  being  guided 
to  the  idea  by  the  Biblical  relation  in  the  case  of  Abraham. 


328  Notes  to  Text. 

80.  This  patient  subsequently  died  of  a  uraemic  complication  following 

on  an  attack  of  fever.  The  man  was  in  his  prime,  and  had  been  of 
most  exemplary  habits.  The  fever  that  he  had  was,  I  had  every 
reason  to  believe,  directly  due  to  the  results  of  imperfect  blood  de- 
puration incident  on  the  irritability  of  his  kidneys,  which,  retroact- 
ively, again  allowed  the  uraemic  condition  to  assume  that  dangerous 
degree  that  suddenly  and  very  unexpectedly  to  his  friends  and 
family  ushered  the  patient  into  eternity.  This  man  had  only  been 
merely  inconvenienced  by  his  prepuce  up  to  the  time  that  it  cai;sed 
his  death.  It  is  interesting  to  observe  what  little  trifles  bring  about 
the  end  of  some  men.  The  unlucky  habit  of  putting  the  royal 
countenance  on  paper  brought  Louis  XA'I  to  a  sudden  halt  at 
Varennes,  and  his  head  to  the  scaffold.  The  lucky  meeting  of  the 
aides  of  Bonaparte  and  Desaix  between  Novi  and  Marengo  gave  to 
France  its  empire  and  to  Europe  the  enlightenment  that  was  diffused 
by  that  event.  If  such  trifles  afi'ect  individuals  and  nations,  we  must 
not  be  astonished  that  the  little  useless  prepuce  should  be  endowed 
with  the  mischief-working  power  of  the  historical  old  cow  and 
kerosene  lamp  that  reduced  Chicago  to  ashes. 

81.  In  the  London  Lancet  for  18S5  there  is  a  very  interesting  communica- 

tion at  page  46  on  this  subject.  There  is  no  doubt  but  that  the  pre- 
puce offers  the  best  skin-grafting  material. 

82.  In  the  seventeenth  volume  (third  series)  of  "Guy's  Hospital  Reports  " 

there  is  a  most  interesting  report  at  page  243  of  a  case  of  skin-grafting 
that  was  performed  by  Thomas  Bryant.  The  case  was  an  extensive 
ulcer  resulting  from  an  injury.  Bryant  took  some  skin-grafts  from 
the  man's  arm  and  some  from  a  colored  man  in  an  adjoining  bed. 
The  account  gives  the  dally  report  as  taken  from  the  note-book  of 
Mr.  Clarke,  and  is  accompanied  by  a  colored  plate  to  illustrate  the 
subject;  the  proliferation  of  the  black  skin  is  astonishing.  In 
closing  the  report  Mr.  Clarke  says  :  "But  in  the  figures  depicted  the 
amount  of  increase  in  the  black  patclies  will  be  well  seen.  In  ten 
weeks  the  four  or  five  pieces  of  black  skin,  which  together  were  not 
larger  than  a  grain  of  barley,  had  grovTn  twentyfold,  and  in  an 
another  month  the  black  patch  was  more  than  one  inch  long  by  half 
an  inch  broad,  the  black  centres  of  cutiftcation  having  clearly  grown ' 
very  rapidly  by  the  proliferation  of  their  own  black  cells." 

83.  American  Journal  Med.  Sciences,  vol.  Ix. 

84.  "Circumcision."     By  Dr.  A.  B.  Arnold,  of  Baltimore. 

85.  "De  la  Circoncision."'    By  Dr.  S.  Bernheim.    Paris. 

86.  The  reader  is  referred  to  a  very  interesting  paper  detailing  conditions 

of  adhesions  in  the  American  Journal  Med.  Sciences  for  July,  1872. 
It  is  taken  from  the  Hungarian  of  M.  Bokai. 

87.  JVeiv  York  Med.  Journal,  vol.  xxvi. 

88.  Avierican  Journal  Med.  Sciences,  vol.  Ix. 

89.  Dr.  Vanier  describes  this  operation  of  Celsus  mentioned  by  Vidal  in 

bis  work  on  "  Circumcision,"  at  page  294,  which  consisted  in  making, 
by  a  circular  incision  immediately  back  of  the  glans,  like  in  a  circu- 
lar amputation,  a  complete  detachment  of  the  integument  from  back 
of  the  corona.  The  penis  was  then  made  to  retreat  into  the  sheath 
thus  made  and  a  short  catheter  introduced  into  the  urethra,  to  the 
end  of  which  the  free  end  of  the  new  preputial  fold  was  made  fast, 
a  piece  of  oiled  lint  being  interposed  between  the  raw  inner  surface 


Notes  to  Text.  329 

and  the  glans.  Another  operation  consisted  in  forcibly  drawing  the 
integument  forward  and  in  making  a  number  of  transverse  incisions 
in  the  integument  so  as  to  assist  its  extensibility.  By  these  means  it 
was  drawn  sufficiently  forward  so  as  to  fasten  it  to  a  canula  or 
catheter  made  fast  in  the  urethra.  But  it  can  well  be  imagined  that 
a  person  must  possess  the  most  exalted  idea  of  the  physiological 
needs  of  a  prepuce  and  feel  the  most  sensitive  need  of  such  an  ap- 
pendage to  submit  to  the  first  of  these  operations,  although  it  is 
more  than  probable  that  many  Jews  submitted  to  the  operation  in 
the  days  of  Celsus  to  avoid  being  exiled  or  plundered  of  all  their 
possessions.  The  resulting  prepuce  could  not  have  been  a  much 
more  unsightly  appendage  than  that  which  ornaments  the  over- 
burdened virile  organ  of  many  Christians,  and  there  is  no  doubt  but 
that  in  many  cases  they  passed  muster. 

90.  "Circumcision."    Dr.  A.  B.  Arnold. 

91.  Ashhurst.     "Int.  Enc.  Surgery,"  vol.  vL 

92.  "  Pertes  Seminales." 

93.  "Circoncision."    Dr.  Vanier,  du  Havre. 

94.  "Dictionaire  des  Sciences  Medicales." 

95.  Erichsen's  "Surgery,"  page  1144.    Edition  of  1869. 

96.  Medical  News  of  Philadelphia,  page  11-5.    Vol.  for  1860. 

97.  "Pertes  Seminales."    In  the  fourth  American  edition  of  the  English 

translation  of  ^NIcDougall  of  Lallemand  we  find  that  he  fully  appre- 
ciated the  dangei-s  that  lurk  in  a  prepuce.  At  page  216  he  says : 
"Such  is  the  condition  which  the  parts  present  in  cases  of  recent 
balanitis,  and  these  are  the  inflammations  and  ulcerations  that  cause 
more  or  less  extensive  adhesions  of  the  prepuce  to  the  glans.  Such 
adhesions  are  generally  cellular,  but  sometimes  fibrous  or  even  carti- 
laginous, according  to  the  severity  and  frequent  repetition  of  the  in- 
flammation. Various  degrees  of  induration  also  results  according  to 
the  intensity,  the  duration,  and  the  frequency  of  the  phlogosis.  Thus, 
1  have  often  found  a  mucous  membrane  hardened,  thickened,  and 
covered  with  numerous  papillae,  sometimes  fibrous  or  cartilaginous, 
with  thvee  times  its  natural  thickness.  I  have  also  met  with  cases  in 
which  the  prepuce  has  become  cancerous.  I  have  operated  in  several 
cases  of  cancer  of  the  penis,  too,  which  certainly  arose  from  no  other 
cause.  The  patients  were  generally  peasants  between  fifty  and  sixty 
years  of  age,  who  had  never  known  other  than  their  own  wives,  but 
who  had  frequently  suffered  from  balanitis  attended  by  abundant 
discharge,  swelling  of  the  prepuce,  and  excoriation  of  its  opening, 
which  was  so  contracted  as  to  prevent  the  passage  of  the  glans.  I 
have  seen  one  case,  also,  in  which  balanitis,  irritated  by  a  forced 
march  and  the  abuse  of  alcoholic  stimulants,  passed  into  gangrene, 
by  which  the  greater  part  of  the  glans  was  destroyed.  Such  have 
been  the  accidents  which  I  have  observed  on  those  whose  prepuce 
was  too  narrow  to  permit  the  glans  being  uncovered;  accidents  which 
I  can  only  attribute  to  the  long  retention  of  the  sebaceous  matter 
in  a  kind  of  cul-de-sac,  into  which  a  certain  quantity  of  urine  passes 
every  time  the  patient  makes  water." 

98.  Claparede.    "  La  Circoncision." 

99.  Baron  Eoyei-.    "Traite  des  Maladies  Chirurgicales,"  vol.  x,  page  370. 
100.  I  have  practiced  considerably  among  the  Jewish  people,  but  I  have 

never  seen  their  elderly  men  suffer  with  prostatic  troubles  like  our 


330  Notes  to  Text. 

own  people  who  are  unclrcumcised.  From  having  observed  the 
tendency  to  prostatic  complications  in  young  people  with  trouble- 
some prepuces,  and  that  the  great  number  of  the  elderly  people  who 
are  affected  with  prostatic  disease  or  enlargement  are  the  unlucky 
possessors  of  long  or  large  prepuces,  I  have  arrived  at  the  conclu- 
sion that  the  prepuce  can  be  entered  as  a  factor  in  the  etiology  of 
enlarged  prostate. 

101.  I  have  now  under  my  care  a  poor  consumptive  who  has  all  the  appear- 

ance of  having  always  been  as  virtuous  as  Joseph,  but  who,  unlike 
Joseph,  has  from  infancy  had  as  a  constant  companion  a  long,  miser- 
able, smegmanous,  and  annoying  prepuce.  The  young  man  has  an 
oedema  which  first  affected  his  feet,  but  one  day,  owing  to  the  irrita- 
tion of  a  slight  balanitis,  the  prepuce  swelled  at  once  ;  it  proceeded 
through  the  penis  integument  to  the  scrotum ;  the  penis  itself  re- 
tracted, leaving  the  integument  and  scrotum  to  assume  a  translu- 
cent, puffy,  cork-screw  appearance  and  attitude  ;  from  its  labyrinthic 
passage  the  urine  slowly  dribbles  during  urination  in  a  scalding 
stream.  In  addition  to  the  physical  sufferings,  he  is  tormented  by  the 
knowledge  that  his  friends  attribute  all  his  disease  and  troubles— 
since  the  occurence  of  the  penile  oedema — to  the  fact  that  his  earlier 
manhood  must  have  been  indiscreet,  as  well  as  sinful.  The  laity  can- 
not connect  any  penile,  scrotal,  or  testicular  disease  with  anything 
except  venereal  disease ;  and  if  the  physician  attempts  to  explain 
■  matters,  they  simply  look  upon  it  as  the  good-natured  and  well- 
intentioned  efforts  of  the  doctor  to  deceive  them  and  to  cover  up 
the  shortcomings  of  some  frail  mortal.  Many  a  poor  fellow  lias  to 
leave  this  world  under  a  cloud  of  mistrust  and  a  bad  odor  of  past 
devilti'y  to  which  he  is  not  entitled,  and  suffer  all  this  in  addition  to 
all  his  physical  ills,  owing  to  his  having  been  ornamented  through  life 
with  an  annoying  prepuce, — the  luckless  heritage  of  having  been 
born  a  Christian.  Columbus  in  chains  moralizing  on  the  ingratitude 
of  this  world  is  nothing  to  the  poor  invalid  with  a  swollen  prepuce, 
innocently  acquired,  silently  "cussing  "  the  ignorance  of  his  relatives 
and  friends. 

102.  This  patient,  on  convalescing,  suffered  considerfible  from  the  action 

of  numerous  small  carbuncles,  resulting  from  the  toxsemic  con- 
dition induced  by  the  partial  suppression  of  urine  that  he  at  times 
suffered  from,  and,  when  nearly  well,  brought  on  a  serious  relapse 
by  the  mail-bag  appendage  at  the  penis  working  up  the  organ  into 
a  state  of  erection.  While  so  situated  he  had  intercourse,  and  from 
99°  his  temperature  immediately  rose  to  104H°i  where  it  remained 
for  several  days,  lengthening  out  his  illness  by  several  weeks,  into 
along-protracted  convalescence.  The  man  is  not  yet  circumcised, 
and,  from  the  knowledge  that  I  have  of  his  tendency  to  uraemia,  I 
feel  that,  although  in  his  prime,  a  fever  or  an  accident  may  take  him 
off  at  any  moment. 

103.  In  looking  over  the  literature  of  reflex  neuroses  and  more  direct 

injurious  results,  I  find  that  George  Macilwain,  in  a  work  on  "Sur- 
gical Observations  on  the  More  Important  Diseases  of  the  Mucous 
Canals  of  the  Body,"  published  in  London  in  1830,  calls  special  atten- 
tion to  the  case  of  a  man  aged  thirty-eight,  admitted  to  the  Finsbury 
Dispensary,  and  who  was  in  the  cai'e  of  Mr.  Hancock.  The  patient 
was  suffering  from  excruciating  pain  in  different  joints,  the  pain 


Notes  to  Text.  331 

being  so  great  that  he  was  confined  to  his  bed  and  unable  to  stand 
on  bis  feet.  He  was  unable  to  rest  at  nights,  and  neither  rheumatic 
nor  any  other  apparently  suitable  treatment  was  of  any  service. 
Rigors  were  soon  added  to  his  other  troubles,  and  during  their  con- 
tinuance the  pain  in  his  joints  was  greatly  aggravated.  He  was 
referred  to  Mr.  Macilwain  for  treatment,  who  promptly  relieved 
him  by  the  removal  of  a  urethral  stricture,  which  had  quietly  been 
the  cause  of  all  the  disturbance.  It  is  particularly  interesting  that 
even  at  that  early  day  the  reflex  neuroses  and  complications  that 
may  arise  from  the  irritability  of  the  genito-urinary  organs  were  so 
well  understood.  How  well  Dr.  Macilwain  appreciated  the  nicety 
of  these  relations  can  be  seen  from  his  remarks  in  connection  with 
the  above  case,  in  which  he  says  :  "It  may  be  observed  that  the  se- 
verity of  the  symptoms  is  not  always  commensurate  either  with  the 
duration  of  the  disease  or  the  degree  of  stricture,  and  that,  although 
the  progressive  development  of  them  varies  considerably  in  rapidity, 
in  different  individuals,  it  is,  nevertheless,  in  the  latter  stages,  always 
more  rapid."  Macilwain  also  graphically  describes  the  insidious 
approach  of  these  genito-urinary  troubles.  In  speaking  of  stricture 
he  says:  "Although  minute  inquiry  generally  informs  us  that  the 
stricture  has  been  of  some  standing,  and  in  some  instances  has  ex- 
isted for  years,  yet  it  may  happen  that  it  is  only  a  few  months  or  a 
year  since  the  patient's  attention  has  been  directed  to  the  disease. 
This  is  very  intelligible  ;  for,  in  conformity  with  what  we  observe  in 
other  parts  of  the  body,  the  bladder  has  a  power  of  accommodating 
itself  to  a  change  of  circumstances.  Its  strength,  for  a  long  time, 
may  increase  so  correctly  in  proportion  to  the  increase  of  the  ob- 
stacle which  opposes  the  ejection  of  its  contents  that  a  very  consid- 
erable period  elapses  before  the  difficulty  in  making  water  becomes 
cognizable  to  the  patient,  or  it  occasions  an  annoyance  so  trifling  as 
scarcely  to  excite  his  attention.  This  increase  of  strength  in  the 
bladder  frequently  renders  the  formation  of  stricture  so  insidious 
that  the  urethra  at  the  affected  part  is  very  narrow  before  the  indi- 
vidual is  aware  of  the  existence  of  any  contraction  whatever ;  the 
bladder,  however,  at  length  becomes  unable  to  empty  itself,  and  the 
abdominal  muscles  and  diaphragm  powerfully  act  as  coadjutors,  so 
that  each  effort  to  make  water  is  accompanied  by  a  straining  which 
is  very  distressing,  and  the  complete  evacuation  of  the  bladder  is 
often  not  accomplished  even  by  these  combined  forces.  The  strain- 
ing which  accompanies  stricture,  and  which  seems  necessary  to  evac- 
uate the  bladder,  although  it  be  occasionally  exceedingly  annoying 
to  the  patient  at  the  time,  is  more  important  with  reference  to  the 
results  which  are  its  consequence.  I  am  firmly  of  opinion  that  there 
are  a  great  number  of  patients  laboring  under  hernia  which  has  been 
produced  by  no  other  cause.  I  must  confess  that  I  had  seen  a  great 
number  of  instances  of  stricture  in  ruptured  patients  before  I  drew 
any  inference  from^  the  observation  of  their  co-existence."  The 
foregoing  observations  of  Macilwain,  made  in  1830,  are  here  repro- 
duced for  their  clearness  of  expression  and  explanation,  as  well  as 
to  show  what  injuries  can  be  produced  on  the  young  child  afflicted 
with  phimosis.  "We  are,  as  surgeons,  familiar  with  the  anatomical 
and  pathological  changes  there  are  undergone  by  the  bladder  and 
its  lining  membrane,  as  well  as  in  the  ureters  and  kidneys,  in  many 


332  Notes  to  Text. 

cases  of  stricture,  as  well  as  of  the  great  amount  of  prostatic  irrita- 
bility autl  enlargemeut  that  is  due  to  the  same  cause.  How  simi- 
larly these  results  can  be  and  are  actually  produced  by  phimosis  is 
undeniably  expressed  by  the  post-mortem  appearances  in  the  poor 
infant  described  by  Golding  Bird  to  the  London  iNIedical  Hociety, 
and  mentioned  in  the  London  Lancet  of  May  16,  184(5.  The  bladder 
and  ureter  were  like  those  of  a  man  who  had  long  suffered  from 
stricture.  From  the  remarks  of  Dr.  J.  Lewis  Smith,  that  phimosis 
may  be  productive  of  inguinal  hernia  and  prolapsus  of  the  rectum, 
and  the  observations  of  Edmund  Owens  and  Arthur  Kemp,  both 
high  authorit.es  on  children's  diseases,  being  both  connected  with 
children's  hospitals,  as  well  as  the  remarks  of  Mr.  Bryant  in  his 
"Surgical  Diseases  of  Children,"  who  all  concur  in  looking  upon 
phimosis  as  a  great  factor  in  hernia,  Bryant  having  observed  tliirty- 
one  in  tif  ty  consecutive  cases  of  phimosis,  we  are  certainly  warranted 
in  assundng  that  phimosis  is  not  only  a  mere  local  timely  inconveni- 
ence that  will  disappear  with  the  approach  of  puberty,  but  a  con- 
dition which,  in  the  more  easily  affected  organism  of  the  child, — 
lacking,  as  it  does,  that  resistance  that  comes  with  our  prime, — is 
productive  of  serious  harm ;  as  even  the  first  few  years  of  life,  even 
a  few  months  of  infant  life,  with  a  phimosis,  are  sufficient  to  so 
change  the  structures  of  parts  that  the  poor  child  will  grow  into  a 
man  with  an  impaired  kidney  or  sacculated  ureter.  The  strain  re- 
quired to  induce  a  prolapsus  of  the  bowel  or  a  rupture  into  the  in- 
guinal canal  is  exerted  as  much  on  the  bladder,  ureter,  and  kidney 
as  on  the  other  localities.  Physicians  who  have  taken  the  pains  to 
observe  must  have  noticed,  more  than  once,  how  the  child  afflicted 
with  a  phimosis  has  not  only  at  times  to  wait  for  the  stream  of  urine 
to  appear,  there  seemingly  being  some  obstruction  to  its  starting, 
but  how  often  such  a  case  is  afflicted  with  a  stammering,  halting 
urination.  A  child  thus  started  out  into  life,  with  a  defective  kidney 
or  kidneys,  is  sadly  handicapped  in  his  usefulness,  comfort,  or  in 
properly  competing  in  the  race  of  life.  No  parent  would  for  a  mo- 
ment think  of  starting  his  son  in  life  by  giving  him  a  business  that 
is  heavily  nnn-tgaged  at  the  start,  but  many  a  parent  unconsciously 
launches  the  unsuspecting  child  into  a  life  of  such  ill  health — result- 
ing from  a  simple  narrow  prepuce — beside  which  a  heavy  mortgage 
or  a  heavy  yearly  tribute  would  be  but  a  mere  trifle.  I  have  seen 
such  men,  who  in  after  life,  broken-down  and  perfectly  physical 
wrecks,  would  gladly  have  given  all  their  wealth  and  been  willing  to 
have  some  genii  set  them  down  in  the  middle  of  the  Sahara,  shirt- 
less and  pennyless,  provided  they  had  their  health.  To  say  nothing 
of  the  trifling  loss  of  the  prepuce,  these  parties  would  gladly  have 
had  a  foot  or  a  leg  go  with  the  prepuce  if  necessary,  and  have  their 
health. 
104.  1  have  often  performed  dilatation  where,  for  some  reason,  either  the 
timidity  of  the  parents  or  the  health  of  the  child  seemed  to  contra- 
indicate  any  more  radical  procedure.  It  is  customary  to  advise 
mothers  or  the  nurses  to  retract  the  skin  daily,  but  even  after  a 
good  dilatation  I  have  found  as  sudden  a  recontraction,  and  even  in 
the  majority  of  cases,  where  daily  drawing  back  the  skin  might  have 
been  practicable,  the  cries  and  struggles  of  the  child  are  a  positive 
prohibition  to  these  instructions  being  carried  out ;  it  is  not  once  in 


Notes  to  Text.  333 

ten  times  that  it  can  be  carried  out.  I  have  seen  two  verv  annoying 
cases  of  paraphimosis  resulting  from  this  procedure,  the  struggles 
of  the  child  having  prevented  the  return  of  the  prepuce  to  its  proper 
place,  and  the  violent  cryuig  and  sobbing  of  the  child  having  assisted 
to  congest  the  organ. 

105.  It  may  well  be  a  question,  considering  the  well-established  fact  that 

nervous  injuries  and  affections  are  easily  transmissible  and  become 
hereditary,  how  much  feeble-mindedness  is  due  to  an  heredity  origi- 
nally induced  in  either  parent  through  reflex  neuroses  from  the 
genital  organs.  The  Jews  have  a  very  small  percentage  of  feeble- 
minded ;  it  is  true  that  they  have  not  any  inebriates  to  assist  in  their 
manufacture,  but  still  the  absence  of  these  well-pronounced  cases  of 
reflex  neuroses  among  the  race  must  be  largely  ascribed  to  their 
practice  of  circumcision,  as  that  operation  cures  the  gentiles  so 
afflicted. 

106.  I  have  seen  precisely  similar  conditions  resulting  from  a  sphincter- 

ismus being  relieved  by  anal  dilatation.  I  had  one  such  case  who 
had  fallen  into  the  hands  of  a  quack,  who  made  him  believe  that  he 
was  being  affected  with  incipient  softening  of  the  brain  ;  systematic 
dilatation  or  a  rupture  of  the  sphincter  a  la  Van  Buren  is  the 
appropriate  remedy. 

107.  In  the  first  volume  of  the  "American  and  English  Encyclopedia  of 

Law"  there  is  an  interesting  account  of  a  young  child  (who  had  been 
bound  out  by  the  parish  officials)  who  murdered  his  little  bed-fellow 
and,  on  trial  and  conviction,  was  sentenced  to  be  hanged,  but  who  was 
reprieved  by  roj'al  favor  on  account  of  his  tender  years,  the  sentence 
being  changed  to  imprisonment  for  life.  The  little  fellow  was  only 
eight  years  of  age.  On  the  trial  the  boy  said  he  was  driven  to  commit 
the  crime  because  the  other  child  soiled  the  bed.  The  two  children 
being  both  paupers,  it  may  well  be  imagined  that  their  bedding  was 
none  of  the  cleanest  at  the  best,  or  that  their  bed-room  had  the  best 
of  ventilation.  As  at  the  time  the  murder  was  committed  English 
paupers  were  not  treated  in  the  most  humane  manner,  it  is  not  sur- 
prising that  a  nervous,  sensitive  child  would,  under  such  a  combi- 
nation of  circumstances,  be  converted  into  au  insane  murderer. 

108.  The  study  of  prematurely  acquired  impotence  in  the  male  Is  a  most 

interesting  one.  I  have  frequently  seen  it  result  from  the  presence 
of  anal  or  rectal  irritation,  from  haemorrhoids.  I  have  seen  cases 
who  could  not  have  erections,  and  in  whom  all  sexual  desire  was 
extinct  at  a  very  early  age,  who  have  informed  me  that,  although 
unable  to  have  sexual  intercourse  because  of  the  total  absence  of 
sexual  desire,  the  flaccidity  of  the  organ,  and  the  want  of  sound 
physiological  organic  functional  activity  to  suggest  the  thought, 
they  had,  nevertheless,  frequently  been  the  victims  of  nocturnal 
emissions  before  the  totel  extinction  of  the  function.  As  a  rule, 
much  of  this  premature  impotence— induced  by  either  irritation  of 
the  genital  organs  or  rectal  or  anal  troubles— runs  its  unfortunate 
possessor  through  such  a  course  of  physical  incidents  as  described 
by  Hammond,  as  the  wild  Indians  of  the  Southwest  induce  in  the 
mujerado.  At  first  the  sound  organ  responds  in  a  natural  manner 
to  any  stimulus  that  may  affect  it,  but  soon  a  local  satyriacal  con- 
dition is  set  up,  which,  running  a  more  or  less  rapid  period  of  intense 


334  Notes  to  Text. 

activity,  soon  leaves  its  victim  completely,  permanently,  and  hope- 
lessly impotent,  even  as  much  so  as  if  eunuchized  in  the  most  ap- 
proved manner.  Hammond's  description  of  the  manner  in  which 
these  unfortunates  are  manufactured  is  an  interesting  addition  to 
the  facts  contained  in  the  natural  history  of  man,  and  is  as  follows  : 
"Amtyerado  is  an  essential  person  in  the  saturnalia,  or  orgies,  in 
which  these  Indians,  like  the  ancient  Greeks,  Egyptians,  and  other 
nations,  indulge.  He  is  the  chief  passive  agent  in  the  pederastic 
ceremonies  which  form  so  important  a  part  in  the  performances. 
These  take  place  in  the  spring  of  every  year,  and  are  conducted  with 
the  utmost  secrecy,  as  regards  the  non-Indian  part  of  the  population. 
For  the  making  of  a  mujerado  one  of  the  most  virile  men  is  selected, 
and  the  act  of  masturbation  is  performed  upon  him  many  times 
every  day  ;  at  the  same  time  he  is  made  to  ride  almost  continuously 
on  horseback.  The  genital  organs  are  thus  brought,  at  first,  into  a 
state  of  extreme  erethism,  so  that  the  motion  of  tlie  horse  is  suf- 
ficient to  produce  a  discharge  of  seminal  fluid,  while  at  the  same 
time  the  pressure  of  the  body  on  tlie  animal's  back — for  the  riding 
is  done  without  a  saddle — interferes  with  their  proper  nutrition.  It 
eventually  happens  that,  though  an  orgasm  may  be  caused,  emis- 
sions can  no  longer  be  effected,  even  upon  the  most  intense  degree 
of  excitation.  Finally,  the  accomplishment  of  an  orgasm  becomes 
impossible  ;  in  the  meantime  the  penis  and  testicles  begin  to  shrink, 
and  in  time  reach  their  lowest  plane  of  degradation.  But  the  most 
decided  changes  are  at  the  same  time  going  on,  little  by  little,  in  the 
instincts  and  proclivities  of  the  subject.  He  loses  his  taste  for  those 
sports  and  occupations  in  which  he  formerly  indulged,  his  courage 
disappears,  and  he  becomes  timid  to  such  an  extent  that,  if  he  is  a 
man  occupying  a  prominent  jilace  in  the  council  of  the  pueblo,  he  is 
at  once  relieved  of  all  power  and  responsibility,  and  his  influence  is 
at  an  end.  If  he  is  married  his  wife  and  children  pass  from  under 
his  control, — whether,  however,  through  his  wish  or  theirs,  or  by  the 
orders  of  the  council,  I  could  not  ascertain.  They  certainly  become 
no  more  to  him  than  other  women  and  children  of  the  pueblo." 
Hammond  examined  one  of  these  men,  who  had,  as  he  himself  in- 
formed him,  formerly  possessed  a  large  penis  and  testicles  "  grande 
como  huevos,"— as  large  as  eggs.  The  penis  was  in  its  flaccid  state 
and  about  an  inch  and  a  half  in  length,  with  the  glans  about  the  size 
of  a  thimble,  which  it  very  much  resembled  in  shape.  The  glandu- 
lar structure  of  the  testicles  had  disappeared  ;  they  were  atrophied, 
little  besides  connective  tissue  remaining.  He  examined  another 
mujerado  in  the  pueblo  of  Acoma,  who  had  been  so  made  when  at 
about  the  age  of  twenty-six.  The  penis  was  not  more  than  an  inch 
in  length  and  about  the  diameter  of  the  little  finger,  and  of  the  tes- 
ticles there  was  apparently  nothing  left  but  a  little  connective  tissue. 
Both  of  these  men  had  high-pitched  voices.  The  last  one  examined 
was  then  thirtj'-six  years  of  age.  (Hammond  :  "Male  Impotence.") 
The  foregoing  detailed  description  shows  an  extreme  degree  of  re- 
sults produced  by  an  equally  extreme  degree  of  intense  and  persist- 
ent irritation  applied  to  the  genital  organs,  purposely  employed  to 
obtain  certain  results.  In  the  cases  cited  the  irritation  or  excitation 
is  directly  applied,  but  it  is  safe  to  assume  that  reflex  irritability 


Notes  to  Text.  335 

from  the  anus  or  rectum,  or  from  that  of  a  stricture  or  of  a  prepuce, 
will  in  some  cases  produce  a  certain  degree  of  excitation  in  the  tes- 
ticles that  may  result  in  their  functional  or  organic  derangement,  in 
a  degree  proportionate  to  that  of  the  amount  of  excitation  from 
which  they  have  suffered.  That  the  testicles  are  very  apt  to  suffer 
from  the  existence  of  a  stricture  is  a  well-known  fact.  I  have  my- 
self worried  over  a  case  of  stricture,  in  whom  the  attempted  passage 
of  a  filiform  bougie  was  always  immediately  followed  by  a  severe 
attack  of  epididymitis,  and  who  had  always  been  afflicted  with  a 
tenderness  and  a  tendency  to  inflammation  of  the  testes.  I  have 
also  noticed  a  much  greater  tendency  to  orchitis  in  the  wearer  of  an 
irritating  prepuce  than  where  it  was  absent ;  so  that  the  presence  of 
a  satyriacal  tendency,  no  matter  in  what  proportion  of  a  degree  it 
may  be  present,  can  safely  be  assumed  to  result  in  a  corresponding 
degree  of  apathy,  due  to  an  actual  physical  degeneration  of  the 
parts.  That  these  conditions,  when  present  in  any  degree  of  perma- 
nency or  persistence,  will  in  the  end  induce  earlj^  impotence,  I  have 
no  reason  to  doubt.  In  this  regard  we  must  not  overlook  the  fact 
that  persons  with  phimosis,  stricture,  or  other  genital  irritants  and 
impediments,  are  more  liable  to  be  afflicted  with  liaimorrhoids,  pro- 
lapsus ani,  or  other  anal  and  rectal  irritation,  which  retroactively 
assist  in  bringing  about  the  condition  v\nder  question.  How  much 
this  may  have  to  do  with  certain  prolific  peculiarities  among  the 
Jews  may  well  be  questioned  ;  it  is  a  well-known  fact  that  in  London 
the  Jewish  excess  of  male  births  has  been  as  high  as  eighteen  per 
cent.,  while  among  the  Christian  or  Gentile  population  it  is  only  six 
and  one-half  per  cent., — a  somewhat  analogous  condition  of  propor- 
tion being  also  observable  in  the  United  States.  Here,  it  is  accounted 
for,  in  a  measure,  by  Dr.  Billings,  in  the  following  words:  "This 
comparatively  large  proportion  of  males  among  the  Jews  is  probably 
due  to  the  fact  that  the  death-rate  of  their  infants  is  less  for  males, 
as  compared  with  females,  than  it  is  among  the  average  population." 
Children  gotten  during  the  prime  of  life  of  the  parents  are  naturally 
more  virile  and  have  better  stamina  than  those  gotten  before  full 
maturity  is  reached.  If  the  father  is  on  the  verge  of  inipotency  just 
about  the  time  he  is  expected  to  beget  his  best  offspring,  that  off- 
spring cannot  be  expected  to  present  an  extra  amount  of  vitality, 
virility,  or  physical  stamina ;  hence,  the  prepuce  can  be  brought  in 
as  directly  tending — in  no  matter  how  small  the  degree  it  may  be, 
but  nevertheless  a  factor— to  the  physical  degeneracy  of  the  race,  as 
■well  as  it  demonstrates  the  existence  of  some  law  for  the  production 
of  the  sexes  which  we  do  not  as  yet  fully  comprehend.  Aside  from 
the  above  considerations,  there  are  those  of  the  actual  bar  to  the  in- 
crease of  population  which  the  prepuce  induces,  either  by  primarily 
being  the  cause  of  impotence  or  by  direct  interference,  as  already 
mentioned,  and  the  impotence  that  naturally  results  from  the  causes 
set  forth  in  this  note.  The  results  of  a  prepuce  are  certainly  such 
as  must  act  like  a  moist,  warm,  and  oily  poultice  to  the  irritability 
induced  in  the  most  confirmed  Malthusian  when  contemplating  the 
— to  him — rapid  and  unwarranted  increase  of  population. 


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Cincinnati  Lancet  and  Observer,  vol.  xvi. 

Statistics  and  Climate  of  Consumption.    Millard. 

Traite  des  Maladies  Chirurgicales,  vol.  x.    Baron  Boyer.    Paris,  1825. 

Dictionary  of  Medicine.    Quain.    New  York,  1884. 


INDEX. 


Abolishment    of   circumcision    by 
Christians,  18 ;  by  the  Romans, 
66 
of  eunuchism  in  Italy,  91,  96 

Abraham,  32 

Absence  of  penis,  13 
of  testicles,  105 

Abyssiniaus,  carry  ofifthe  male  mem- 
bers of  slain  enemies,  30 ;  cir- 
cumcised bishop  among  the,  61 

Acosta,  Rev.  Father,  on  Mexican 
circumcision,  47 

Adams,  Dr.  C.  Powell,  of  Hastings, 
Minn.,  198 

After-treatment  of  circumcised 
Hebrews,  158 

Agnew,  D.  Hayes,  on  penile  can- 
cer, 230  ;  on  eczema  as  a  reflex 
neurosis  from  phimosis,  320 

Albutt,  T.  Clifford,  on  primary 
cause  of  disease,  13 

American  circumcision,  47;  infibu- 
lation  and  muzzling,  48 

Amputation  of  penis,  230,  233,  247 

Androgynes,  118 

Augleria,  Pierre  d',  on  American 
circumcision,  47 

Apis,  the  white  bull,  sacred  to  the 
Egyptians,  39 

Apollo  Belvidere,  as  evidence  of 
exactness  of  ancient  sculp- 
ture, 62 

Apure  Indians  and  their  circum- 
cision, 48 

Arabian  circumcision,  38 ;  prosti- 
tutes, 323 

Arias  Montan,  on  Mexico,  46 

Arnold,  Dr.  A.  B.,  of  Baltimore, 
25,  219,  220,  223 

Asthma  as  a  reflex  neurosis  from 
genital  irritation,  291 

Australian  circumcision,  44;  opera- 
tion on  the  urethra,  56 

Author's  modification  of  circum- 
cision, 307 

Aztec  circumcision,  46 


Ballance,  C.  W.,  dressing  after  cir- 
cumcision, 317 

Bamboo  stick  worn  in  vagina  as  a 
chastity  protector,  52 

Baptismal  ceremonies  of  Omaha 
Indians,  56 

Barbarous  Arabian  marriage  cus- 
tom, .54 
mutilations  of  Guamo  and  Otho- 
maco  Indians,  48 

Bas-relief  representing  Egyptian 
emasculation,  31 

Bassouto  circumcision,  43 

Battos  circumcision,  45 

Baumgartner's  devout  and  chaste 
dervish,  49 

Beale,  Sir  Lionel,  on  blood  changes, 
296 

Bell,  Dr.  John,  on  Jewish  hygiene, 
181 
Dr.  J.  Royes,  191,  223,  229,  239 

Bells,  jingling  of,  under  the  skirts, 
denotive  of  Judean  virginity, 
52 

Belt  of  brass  mail  to  insure  female 
chastity,  51 

Berbers,  mutilations  of  their  prison- 
ers, 30 

Bergmann,  of  Strasburg,  20,  27 

Bergson,  Dr.,  160 

Bernheim,  Dr.,  on  freedom  of  Jews 
from  syphilis,  195 ;  on  prepu- 
tial statistics,  220  ;  on  circum- 
cisial  operation,  312 

Bernoulli,  Prof.,  of  Bale,  168 

"Beth  Tosef"  of  Joseph  Karo, 
153 

Biblical  vouching  for  homoeopathy, 
113 

Billings,  Dr.  John  S.,  U.  S.  Army, 
on  Jewish  vital  statistics,  174  ; 
on  cancer  amongst  Jews,  230 

Bird,  Dr.  Golding,  on  phimosis,  257 

Bishop  of  Abyssinia  accused  of 
heresy  on  account  of  circum- 
cision, 64 

(339) 


340 


Index. 


Blood    of    prepuce    spiliikled    on 
bride's  veil,  55 ;    spriukled  on 
ears  of  corn,  5(5 
changes  as  starting-points  of  dis- 
ease, 293,  298 

Bobovii,  Alberti,  on  Mohammedan 
circumcision,  39 

Bogera,  or  African  circumcision, 
44 

Bokai,  on  preputial  statistics,  220 

Bornean  circumcision,  45 

Bowditch,  Henry  I.,  on  Jevyish  vital 
statistics,  176 

Boyer,  Baron,  on  cancer  of  the 
penis,  232 ;  on  gangrene  of  the 
penis,  237 

Brett,  Dr.  F.  H.,  case  of  hyper- 
trophy of  prepuce,  251 

Bryant,  Thomas,  on  skin-grafting, 
328 

Bumstead,  on  circumcision,  310 

Burial  of  Algerine  prepuces  in  the 
sauds  of  the  deserts,  39 

Cahen,  Dr.,  on  diminished  sensi- 
bility of  glans  after  circumcis- 
ion, 224 

Calculus,  liability  of  the  Chinese 
to  preputial,  248;  Dr.  J.  G. 
Kerr,  on  preputial,  248  ;  C.  H. 
Martin,  of  Mobile,  on  climatic 
influence  on,  248  ;  Prof.  Enoch, 
of  Berlin,  on  preputial  and 
vesical  calculi,  249;  Clapar^de's 
case,  249  ;  composition  of  pre- 
putial, 249 ;  Civiale's  case,  249 ; 
induced  by  phimosis,  287 

Canarj'  Islands,  remaius  of  an  ante- 
diluvian world,  25 

Cancer  of  the  penis,  232  ;  views  of 
Jonathan  Hutchinson  as  to  its 
origin,  226  ;  precancerous  stage 
of,  226 ;  views  of  LallemaTid, 
228,  329  ;  statistics  of,  231 ;  Cul- 
lerier  on,  231 ;  fifty  cases  re- 
ported by  Dr.  Zielewicz,  233 ; 
early  mention  of,  234;  views 
of  Prof.  John  C.  Warren,  235 ; 
views  of  Walshe,  235 

Canon  of  St.  John  Lateran  and  his 
profane  doubts,  74 

Carter,  Dr.  Wm.,  on  toxic  urines, 
298 

Casalis,  M.,  on  Bassouto  circum- 
cision, 42 


Cases  of  spontaneous  circumcision, 
58 

Castration,  etymology  of  the  term, 
80 ;  as  a  self-sacrilice  to  dei- 
ties, 89 

Celsus,  on  Roman  inflbulation,  50; 
on  operations  on  the  prepuce, 
302,  313,  328;  originator  of 
Cloquet's  operation,  313 

Chabas,  M.,  description  of  Egyp- 
tian bas-relief,  23 

Charlemagne  endows  an  abbej' 
with  a  holy  pi-epuce,  72 

Charles  V  sacks  Rome,  and  robbery 
of  the  holy  prepuce,  73 

Chastity  among  Egyptian  der- 
vishes, 49;  belt  of  brass  mail 
of  the  Ethiopians.  51  ;  plug  of 
bamboo  of  Soudan,  51  ;  ring', 
to  insure  chastity  in  the  mal'! 
mentioned  by  Nelaton,  54; 
enforced  among  the  Hindoo 
bonzes  by  inlibulation,  54; 
among  the  Cybelian  priest- 
hood, 89  ;  Greek  monks,  ideas 
of,  89;  comparative,  among 
the  different  religious  creeds  of 
Prussia,  195 

Chinese,  peculiar  liability  of,  to  cal- 
culous disease,  248 ;  considered 
a  delicate  diet  by  Australian 
cannibals,  327 

Chippeway  Indians  and  circumcis- 
ion, 23 

Caivalry  of  the  male  Hottentot,  60 

Christian  abolishment  of  circum- 
cision, 18;  circumcision  in 
Abyssinia,  63 

Circumcised  phallus  as  a  religious 
and  civic  symbol,  35;  races 
peculiarly  exempt  from  syphi- 
lis, 192 

Circumcising  knife  (see  Knife). 

Circumcision,  abolished  by  Chris- 
tians, 18  ;  among  Chippeway 
Indians,  23;  among  the  Atlan- 
teans  of  Plato,  23  ;  among  the 
Phoenicians,  34;  among  the 
Egyptians,  34;  Arabian,  35, 
54 ;  during  the  reign  of  Psam- 
metich,  34;  civil  and  religious 
symbol  of  ancient  Egypt,  35; 
Aztec,  46 ;  amona-  the  Mijes, 
46  ;  Mexican,  46  ;  Totonac,  46  ; 
among  the  Orinoco  Indians,  47 


Index. 


341 


Circumcision,  the  climatic  limits 
of,  as  a  general  rite,  47  ;  in  the 
Island  of  Cosumel,  47  ;  in  Yu- 
catan, 47  :  in  old  Florida,  47  ; 
Apure  IndianSj^48  ;  among  the 
Amazons,  56 ;  accidental  case 
of,  mentioned  by  Cullerier,  57  ; 
spontaneous,  58  ;  abolished  b}' 
the  Eomaiis,  6(3;  destroying 
marks  of,  68  ;  of  Abraham,  143 ; 
Hebraic,  143  ;  not  practiced  in 
the  wilderness,  143 ;  physical 
conditions  that  exempt  Jewish 
children  from,  144,  145 ;  de- 
scription of  Hebraic,  by  Mon- 
taigne, 146 ;  as  a  cure  for  epi- 
lepsy, 261 ;  as  a  preventive  of 
hernia  or  rupture,  363 ;  as  a 
preventive  to  prolapsus  of  the 
bowel,  263  ;  as  a  preventive  of 
idiocy,  266;  as  a  cure  for  dys- 
pepsia, 270,  271 

Civiale,  on  moral  effects  of  penis 
amputation,  247;  case  of  phi- 
mosis and  preputial  calculi,  349 

Claparede,  on  evils  i-esulting  from 
the  prepuce,  229 ;  ou  preputial 
calculi,  249 

Clarke,  Sir  Andrew,  on  renal  in- 
adequacy, 300 

Clavigero,  on  Mexican  circum- 
cision, 46 

Climatic  limits  of  circumcision,  65 

Cloquet  operation,  306,  316 

Colchis,  colony  of,  33 

Constantine  punished  circumcisers 
with  death,  66 

Constipation  as  a  divine  attribute, 
288  ;  as  a  result  of  phimosis 
and  its  results,  292 

Consumption,  relation  of,  to  Jewish 
race,  178,  179 

Controversy  about  the  holy  pre- 
puce, 73 

Convent  of  St.  Corneille  and  the 
holy  knife,  78 

Convulsions  induced  by  phimosis, 
260,  261 

Cullerier,  accidental  circumcision, 
57  ;  on  penile  cancer,  331 

Cybelian  priesthood  and  castration , 


Dakotas,    the    white    bull    sacred 
among  the.  36 


David  and  the  Philistine  prepuces, 
31 

Debreyne,  trappist,  monk,  and  phy- 
sician, 324 

Delange,  on  Arabian  circumcision, 
37 

Delpech,  on  female  circumcision, 
36 

Demarquay,  on  penile  gangrene, 
236 

Dervishes,  holy  and  chaste,  49 

Ditference  between  Turkish  and 
Buddhist  heaven,  116 

Dilatation  of  prepuce,  308,  313, 333 

Donnelly,  Hon.  Ignatius,  on  Atlan- 
teau  circumcision,  23 

Dressing  in  cases  of  retraction  of 
penile  skin,  304;  C.  W.  Bal, 
lance's,  after  circumcision,  317 ; 
A.  G.  Miller's,  318 

Du  Bisson,  on  Soudanese  harems, 
53 

Dyspepsia  induced  by  preputial  irri- 
tation, 270,  271 

Ebers,  Dr.,  ou  Karnac  bas-relief, 
23 

Eczema  induced  by  phimosis,  320 

Effect  of  the  holy  prepuce  on  the 
hands  of  a  lady,  74 

Effects  of  age  on  the  prepuce,  385 

Egypt,  uncircumcised  persons  not 
allowed  to  study  in  ancient,  34 

Egyptians  emasculated  their  prison- 
ers, 30 

Emasculation,  its  early  practices 
and  evolutions,  29 ;  of  Uranos, 
83 

Emperor  Adrian  forbids  circum- 
cision, 66 

Endurance  and  fortitude  of  Arabs, 
55 

Enforced  continence  and  its  effects 
on  the  penis,  61 

Ennery,  M.,  Grand  Rabbi  of  Paris, 
158 

Enoch,  Prof,  of  Berlin,  on  prepu- 
tial calculi,  249 ;  on  results  of 
phimosis,  266  ;  on  enuresis,  277 

Enuresis,  275 

Epilepsy,  induced  by  the  prepuce, 
258,  261,  301 

Epstein,  Dr.,  of  Cincinnati,  156 

Erichsen,  Prof.,  on  cancer  of  the 
penis,  338 


342 


Index. 


Ethics  at  the  battle  of  Fontenoy,  76 

Ethiopian  infibulatlon  of  infant 
females,  51 

Eunuchism,  beneficial  to  guardians 
of  public  funds,  84 ;  as  ex- 
cluding from  the  priesthood, 
90 ;  in  Italy,  91 ;  in  China,  91, 
93;  in  India,  92;  in  the  Sou- 
dan, 99;  and  music,  94;  as  a 
punishment,  97;  mortality  at- 
tending its  manufacture,  91,  92, 
93,  99,  100,  107 ;  does  not  pre- 
vent copulation  at  all  times, 
92,  100,  101,  102,  103  ;  manner 
of  procedure  among  the  Pagan 
priesthood,  106 ;  prices  of  eu- 
uuchs,  99 ;  numbers  annually 
made,  91,  98  ;  fecundating  eu- 
nuch of  Mecca,  100 ;  Velutti, 
the  opera-singer,  102  ;  eunuchs 
as  possessors  of  harems,  90  ; 
eunuch  warriors  and  statesmen, 
90 

Evidence  of  circumcision  on  Egypt- 
ian monuments,  23 

Extraordinary  results  of  phimosis, 
283 

Female  circumcisers  in  Arabia,  36 

Females  subject  to  preputial  reflex 
neuroses,  267,  268 

Flaccourt,  M.  Martin,  account  of 
the  Madecasses,  54 

Fothergill  and  the  unlicensed  prac- 
titioner on  renal  pathology,  77 

French  war-office  records,  on  Jewish 
vital  statistics,  175 

Frenum,  statistics  relating  to  ab- 
normalities of,  221 

Frerichs'  ammonisemia,  300 

Fresnel,  M.,  on  marriage  circum- 
cision, 54 

Full-moon  rites  among  the  Bassouto 
maidens,  44 

Galen,  on  the  flaccid  virile  member, 

60,  61 
Gangrene  of  the  penis,  236 
Golden  padlocks  worn  on  prepuce 

for  five  years,  54 
Greek  and  Roman  statuary  and  the 

penis,  60 
Greek   monks'   object   in    infibula- 

tions,    54 ;    extreme    ideas    of 

chastity,  89 


Gregg,  Dr.  Robert  J.,  operative 
procedure,  330 

Grifiiith,  Dr.  J.  D.,  cases  of  reflex 
irritation,  261 

Gross,  Prof.  S.  D.,  on  penile  can- 
cer, 230 ;  operations,  320 

Grotius  and  the  origin  of  the  Peru- 
vians, 46 

Guimara,  the,  153 

Guinzburg,  Dr.,  on  Jewish  vital 
statistics,  176 

Gumilla  and  his  South  American 
voyages,  47 

Haemostatic  powders,  160 

Hai-e,  Prof.  Hobart  A.,  on  circum- 
cision, 301 

Haskins,  Dr.  A.,  on  Jewish  vital 
statistics,  176 

Heaven,  Turkish,  115;  Buddhist, 
116 

Hebraic  idea  of  parental  origin  of 
constitution  of  the  child,  144 

Hebrew  Consistory  of  Paris,  157 

Hebrew  words  in  Central  America 
languages,  24 

Hebrews,  attempts  to  efi"ace  signs 
of  circumcision,  69;  secretly 
circumcise  their  dead,  68 ; 
Hebrew  vital  statistics,  169  to 
179  ;  as  proverbial  good  livers, 
171 ;  escape  epidemics,  173 ; 
peculiarly  free  fi-om  syphilitic 
taint,  191 ;  their  circumcision 
suitable  to  young  children,  306 

Heliogabalus,  Emperor,  M'as  cir- 
cumcised, 66 

Henry  III  of  France  as  a  Moslem 
godfather,  64 

Henry  V  of  England  and  the  holy 
prepuce,  71 

Heraclius,  Emperor,  persecuted  the 
Jews,  67 

Hermaphrodiles,  earliest  mention 
of,  117 ;  pederasty  causes  be- 
lief in  their  existence,  118, 119, 
120  ;  Debierre  on,  123  ;  notable 
cases  of,  124,  125,  127,  128 

Hernia  induced  by  phimosis,  263 

Herodotus,  his  views  adopted  by 
Voltaire,  22 ;  visits  Egypt,  34 

Herrera,  on  Mexican  circumcision, 
47 

Hey,  Dr.  William,  on  preputial 
cancer,  227 


Index. 


343 


Hindoo  devotee  wears  a  six-inch 
riug  in  prepuce,  54 

Hitouch,  156 

Holgate,  Dr.,  of  New  Tork,  on  pre- 
putial adhesions,  220  ;  on  pre- 
putial dilatation,  308 

Holy  circumcision,  70,  78 
prepuces,  70,  72 

vinegar      and     its      miraculous 
effects,  79 

Horner,  Surgeon  U.  S.  Navy,  on  the 
worship  of  Venus  Porcina,  193 

Horrible  marriage  performance,  5i 

Hottentot  restriction  on  making 
twins,  60 

Hough,  Dr.,  on  Jewish  longevity, 
173 

Humphry,  Geo.  Murray,  on  "Old 
Age,"  14 

Hutchinson,  Dr.  Jonathan,  ou  the 
precancerous  stage  of  cancer, 
226 ;   on  urethral  child,  300 

Hypospadias,  as  a  heredity,  129; 
artificially  made,  56  ;  formerly 
led  to  belief  in  hermaphro- 
dism,  129  ;  fecundation  in,  129  ; 
difficulty  in  determining  sex 
owing  to,  131 

Idiocy  induced  by  phimosis  and 
preputial  adhesions,  265,  269 

Impious  wretch  steals  the  holy 
prepuce,  74 

Impotence,  holy  vinegar  and  shri- 
nal  observances  in,  71  to  81 

Indians  and  circumcision,  46  to  48 

Induration  of  prepuce,  250 

Infibulation  practices,  48  to  52 

Isis  inaugurates  Osirian  rites,  29 

Isserth,  Rabbi  Israel,  153 

Jansen,  Surgeon  of  the  Belgian 
Armies,  on  frenum  deformi- 
ties, 221 

Jews'  letters  to  Voltaire,  22;  Jews 
(see  Hebrews). 

Judaism  unfavorable  to  religious 
insanity,  166 

Justinia,  Emperor,  persecuted  the 
Jews,  67 

Karo,    Joseph,     and    the     "  Beth 

Yosef,"  153 
Kemp,  Dr.  Arthur,  on  phimosis  as  ' 

a  cause  of  hernia,  264  I 


Kerr,  Dr.  J.  G.,  on  Chinese  prepu- 
tial calculi,  248 

Keyes,  Dr.  E.  L.,  on  composition 
of  preputial  calculi,  249,  264 

King  David,  the  first  homoeopathic 
patient,  113  ;  secui-es  two  hun- 
dred Philistine  prepuces,  31 

Knife,  circumcising,  used  in  ancient 
Egyptian  rite,  23  ;  of  shell  used 
by  Tonga  Islanders,  45 ;  of 
stone  used  by  Australians,  45 
of  the  holy  circumcision,  78 
made  of  rattan  among  the  Fiji 
Islanders,  327 

Lafargue,  on  Australian  circum- 
cision, 44 

Lallemand,  on  masturbation,  223; 
on  tendency  to  preputial  can- 
cer, 328,  339;  on  circumcision, 
317 

Las  Casas,  on  Aztec  circumcision, 
46 

Leech,  Dr.  T.  F.,  on  preputial  irri- 
tation, 260 

Letenneur,  Prof.,  on  the  knife  of 
the  holy  circumcision,  78 

Life-insurance  and  the  circumcised, 
290 

Lisfranc,  rules  for  operations  on 
the  penis,  232;  on  recession  of 
the  body  of  the  penis,  306 

Livingstone,  on  Bassouto  circum- 
cision, 44 

Longevity  of  Hebrews.  162, 169, 179 

Lonyer-Villermay,  M.,  on  female 
circumcision,  36 

Louis  XVI  as  a  candidate  for  the 
rite,  301 

Love,  Dr.  I.  N.,  on  the  Mosaic  law, 
363 

Lumholtz,  on  Australian  hypospa- 
dias, 56 

Macilwain,  on  reflex  neuroses,  330 
Magruder,  Dr.  G.  L.,  on  reflex  irri- 
tation, 261 
Maids  as  heat  radiators,  114 
Maimonides,    Jewish     i-abbi     and 

physician,  32,  144,  153 
Malay  circumcision,  45 
Malgaigne,  operative  views,  313,316 
Mapato,  or  mystery  hut,  42 
Marriage  preceded  by  circumcision^, 
54 


344 


Index. 


Martius  and  Spix,  on  circumcision 

on  the  Amazon,  56 
Mastin,    Dr.    C.    H.,   on   calculous 

disease,  248 
Masturbation,  224 
Maury,   Dr.    Frank,   on    preputial 

statistics,  219 
McLeod,    Dr.    Neil,     circumcision 

operation,  318 
McMahon,  Dr.  W.  R.,  on  reflex  epi- 
lepsy, 261 
Mendelssohn,   Rabbi    Moses,    164, 

168 
Mexican  circumcision,  46 
Mezizah,  or  act  of  suction,  150 
Milah,  156 
Miracles   performed    by   the    holy 

prepuce,  70  to  74 
Mishna,  the,  153 
Mohammed,  65 
Mohel,  157, 158 
Moses,  Dr.,  of  New  York,  preputial 

statistics,  220 
Moses  circumcises  his  son,  150 
Mott,  Jr.,  Dr.  A.  R.,  cases  of  reflex 

iri'itation,  258 
Music,  first  schools  of,  94 
Music  at  Algerine  circumcision,  .39 ; 

at  Mohammedan,  in  Asia,  39  ; 

at  Turkish  feast,  41 

Nelaton,  case  of  infibulation,  54; 
on  penile  cancer,  231 ;  on 
penile  liypertrophy,  252 

Nelson,  Lord,  disregard  for  red 
tape,  77 

New  Caledonian  circumcision,  45 

Newton,  Sir  Isaac,  and  the  storm- 
predicting  cow,  77 

Nicaraguan  baptism  of  blood,  56 

Oath  of  mohel,  158 

Oath.  Egyptianmanner  of  making 
oath,  35 

Ohod,  Battle  of,  36 

Operations  on  the  prepuce,  302 ; 
Cloquet's,  306  ;  Bumstead's, 
310  ;  Hue's,  312  ;  Bernheim's, 
Sedillat's,  313;  Chauvin's,  313; 
Cullerier's,  313  ;  Vanier's,  316; 
Vidal  de  Cassis',  316  ;  Lalle- 
mand's,  317;  A.  G.  Miller's, 
Neil  McLeod's,  318;  Ericlisen's, 
319  ;  Gross's,  320  ;  Van  Buren 
and    Keyes',  320  ;     D.    Hayes 


Agnew's,   320;    Overall's  pro- 
cedure, 321    . 
Origin  of  phallic  worship,  29 

of  human  slavery,  29 
Orinoco,  circumcision  on  the,  47 
Orloth,  penis  or  prepuce?  31 
Osiris  vanquished  by  Typhon,  28 
Othomacos  Indians  and  their  bloody 

rite,  48 
Owen,  Dr.  Edmund,  on  phimosis, 
263 

Packard,  Dr.,  on  preputial  statis- 
tics, 219 

Papal  indulgences  to  worshipers 
of  holy  prepuce,  72 

Paralysis  induced  by  phimosis,  259 

Penis,  absence  of,  132  ;  diminutive 
specimens,  213  ;  amputation  of. 
230,  233,  234,  247;  cancer  of^ 
232  ;  gangrene  of,  236  ;  hyper- 
trophy of,  248,  251,  252 

Periah,  156 

Persecutions  on  account  of  circum- 
cision, 66 

Phoenician  origin  of  circumcision, 
22 

Phimosed  penis  on  ancient  statues, 
60 

Phimosis,  218,  221 ;  as  a  cause  of 
hernia,  263 

Physicians  as  practical  Christians, 
141 

Pooley,  Prof.  J.  H.,  case  of  pre- 
putial irritation,  260 

Popfe,  Rabbi  Rav,  and  the  Ouimara, 
153 

Portuguese  sailors  as  Mohammedan 
proselytes,  40 

Potentia  generandi,  103. 
coeuudi,  104 

Prepuce,  iufibulated,  64;  swallowed 
by  mother,  54 ;  fired  off  in  gun, 
54;  holy,  71;  useful  for  skin 
grafts,  207;  absence  of,  209; 
influence  on  man  at  diflfei-ent 
ages,  225;  induration  of,  250  ; 
warts  of,  250  ;  reflex  neuroses 
from,  2.56 

Preputial  miracles,  72 ;  statistics, 
•219  ;  adhesions,  219,  220 ;  cal- 
culi, 248 

Price,  Dr.  M.  F.,  on  reflex  neuroses, 
265  ;  on  female  preputial  irrita- 
tion, 267,  268 


Index. 


345 


Primitive  phallic  rites,  28 
homcEopaths,  113 

Procedure  in  retraction  of  skin  of 
penis  after  circumcision,  304 

Proselytes,  Mohammedan,  how  cir- 
cumcised, 40,  41 

Public  women    between   decks   in 
U.  S.  Navy,  193 

Puzey,  Dr.,  of  Livei-pool,  on  pre- 
-     putial  skin  grafts,  207 

Pythagoras   32  ;   visits  Egypt,  34 

Ralfe,  on     causes     of    interstitial 

nephritis,  300 
Rameses    II,    circumcision    of    his 

sous,  23 
Ranuey,  Prof.  A.  L.,  on  enuresis, 

282 
Reconstruction  of  a  prepuce,  68,  69, 

328 
Rectum,  prolapsus  of,  induced  by 

phimosis,  263 
Reflex  neuroses  from  preputial  ii-ri- 

tation,  2.54,  330,  331 
Regulations  of  French  Hebrew  con- 
sistories of  1854,  1.57 
Religion,  its  connection  to  insanity, 

166 
Resectricis  nympharum,  profession 

of,  36 
Restriction    on   impregnation,    .57 ; 

on  twins,  60 
Retraction  of  skin    of  penis   after 

circumcision,  303 
Richardson,  Dr.  B.  W.,  on  relation 

of  race  to  disease,  169, 170,  171, 

177 
Ricord's  definition  of  the  prepuce, 

206  ;  operations  on  the  prepuce, 

313 
Roman  infibulation,  .53 
Royal  decree  of  1845  in  France,  157 
Roux,  on  cancer  of  the  prepuce,  227 
Rush,    Benjamin,    and    the   cancer 

quack,  77 

Saint-Germain,  Dr.,   on    preputial 

abnormalities,  264 
Saint  Foutin  and  his  shrine,  78 
Saint  Guerluchon   at  Bourg-Dieu, 

79 
Saint  Guignole  and  the  miraculous 

phallus,  80 
Saint  Coulombs  and  the  miraculous 

prepuce,  70 


Saturnus  the  first  eunuchiser,  83 

Sayer,  Prof.  Lewis  A.,  contribu- 
tions to  medical  science,  255 

Scythians  carry  ofl'  heads  of  the 
slain,  30, 

Self-circumcision,  attempt  at,  203 

Semiramis  first  employs  eunuchs,  85 

Severus  Sulpicius,  on  effects  of  cli- 
mate, .50 

Sham  battles  at  circumcision  feasts, 
37,  41,  42,  44 

She-circumcisers,  36 

Shrine  for  the  recovery  of  impotent 
males,  79 

Smith,  Dl-.  J.  Lewis,  on  preputial 
irritation,  263 

Solomon,  Dr.,  of  Brunswick,  on 
suction,  158 

Soudanese  chastity  protector,  52 

Sphincterismus  due  to  phimosis, 
292 

Spiked  chastity  belt  in  Naples 
museum,  52 

Stallard,  Dr.,  on  Jewish  vital  statis- 
tics, 173 

Sterility  cured  at  sacred  shrines, 
71  to  81 

Stricture  of  urethra  and  phimosis, 
289,  290 

Styptics  used  by  mohels,  1.58,  159 

Syphilis,  statistics  relating  to,  187 
to  199 

Syphilis  and  scrofula,  190 

Taylor,  Dr.  C.  F.,  on  masturbation, 

269 
Totonac  circumcision,  46 
Tonga  Islanders'  rite,  45 
Toxtemia.  resulting  from  phimosis, 

293;  of  von  Jaksch,  294 
Tube,  penis  carried  in,  56 
Tunca  Indian  circumcision,  56 
Turkish  circumcision,  39  to  41 
Tylor,  on  the  Stone  Age  and  circum- 
cision, 336 

Van  Buren  and  Keyes,  on  circum- 
cision, 320 

Vanier  du  Havre,  Dr.,  54,  224;  on 
operations,  316 

Venus,  birth  of,  84 

Vidal  de  Cassis,  on  preputial  opera- 
tions, 316 

Virey,  account  of  Hindoo  bonze, 
54 


346 


Index. 


Virgins'  chain  of  bells  in  ancient 
Judea,  52 

Vital  statistics  of  Jews,  169  to  179 

Voltaire,  on  origins  of  circumcision , 
22 

Von  Jaksch's  definition  of  Tox- 
aemia, 294 

Wadd,  Dr.,  on  preputial  cancer, 227  ; 

on  hypertroph_y  of  penis,  252 
Walslie,  on  preputial  cancer,  235 
Warren,  on  preputial  cancer,  235 
Warts  of  penis  and  prepuce,  250 
Waterman,    Dr.,    on    Jewish   vital 

statistics,  177 
Wax  images  of  penis  deposited  on 

shrines,  79 


Welsh  words  in  Mandan  language, 
24 

Wet  dressing  objectionable  after 
circumcision,  304,  311 

White  Bull,  sacred  among  Sioux 
and  Eg}'ptians,  26 ;  origin  of 
sacredness,  29 

Willard,  Dr.  De  Forest,  observa- 
tions on  the  prepuce,  262 

Wine  at  circumcision  feasts,  151 

Wirthington,  Dr.  F.  J.,  on  prepu- 
tial irritation,  259 

Wise,  Dr.  I.  M.,  on  St.  Paul  the 
apostle,  19 

Worm  an,  Prof.,  of  Brooklyn,  on 
circumcision,  26 


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FACSIMILE  PAGE  FROM  "STANTON'S  PHYSIOGNOMY"— Reduced. 


HOW   TO    REDUCE    SIZE   WITHOUT    LOSING   STRENGTH.  1109 

vpjce.  A  thorough-bred  person  may  belong  to  the  artistic,  me- 
chanical, or  scientific  classes,  either  appreciatively  or  executively ; 
lie  nuist  exhibit  both  gentleness  and  spirit,  as  occasion  requires;  he 
must  be  governed  by  the  law  of  justice;  he  must  make  the  com- 
fort of  his  associates  his  concern,  and  do  what  is  right  in  order  to 
cnliance  tlieir  happiness. 

Tlie  facial  indications  of  thos^  wlio  are  not  thorough-bred,  - 
speaking  physiologically,  are  as  follow:  A  coarse,  thick  skin  ;  a 
"muddy"  complexion,  or  one  permanently  blotched,  pimpled,  or 
discolored;  dull  eyes,  ^ery  small  or  very  large  and  bulging; 
coarse  hair,  or  that  which  is  very  light  or  colorless, — that  is  to  say, 
of  no  ileckled  hue.  I  regard  very  light  colored,  pallid  people  as 
morbid  varieties;  also  those  witli  irregular  teeth,  a  very  small  or 
iil-shapcn  .lose,  small  nostrils,  perpendicular  jaws,  exposed  gums, 
open  mouth,  receding  chin,  or  one  that  projects  greatly  forward, 
ending  in  a  point;  thin,  pallid,  dry  lips;  hollow  cheeks,  flat  upper 
cheeks,  ugly  or  ill-shapen  ears;  a  voice  weak,  thin,  hoarse,  shrill 
or  nasal;  a  long,  cylindrical  neck;  a  high,  narrow  forehead. 

The  undue  development  of  certain  organs  and  systems  of  the 
body  induces  abnormal  conditions,  as,  for  example,  an  excessive 
disposition  of  fatty  tissue.  "When  the  appetite  is  voracious,  or  the 
nutritive  system  uncommonly  active,  too  much  of  the  carbonaceous 
elements  of  tlie  food  are  eliminated,  or,  as  it  often  occurs,  too  much 
carbonaceous  food,  such  as  white  bread,  potatoes,  etc.,  is  consumed 
for  tlie  needs  of  tlie  body;  tlie  consequence  is  an  excess  of  fat, 
which,  in  many  subjects,  impedes  respiration,  prevents  activity, 
and  gives  a  generally  uncomfortable  feeling.  For  this  condition  a 
spare  diet  is  often  prescribed,  but  as  this  is  felt  to  be  a  hardship, 
and  as  few  who  attempt  it  succeed  in  continuing  it  long  enough  to 
produce  satisfactory  results,  it  is  pronounced  a  failure. 

For  this  class  of  people  there  is  a  very  agreeable  and  sure 
method  of  reducing  the  bulk  without  reducing  strength  and  with- 
out compelling  too  great  a  sacrifice  of  the  appetite. 

HOW    TO    REDUCE   THE   SIZE    WITHOUT   LOSING    STRENGTH. 

A  diet  which  will  attain  this  result  is  easily  obtained,  and  of 
it  the  subject  can  use  a  quantity  sufficient  to  allay  the  craving 
for  food. 

This  dirt  consists  of  absolutely  raro  foods,  nothing  cooked 
being  allowed.  This  diet,  of  course,  must  consist  mainly  of  fruits, 
nuts,  grains,  milk,  and,  \^hen  flesh-meat  is  desired,  a  Hamburg 
beefsteak  may  be  partaken  of;  this  steak  is  raw  beef  chopped  fine 
and  seasoned  with  onion,  salt,  pepper,  or  other  condiments;  to 
this  may  be  added  raw  oysters  and  clams.     Every  kind  of  fruit 


FACSIMILE  PAGE  FROM  '^STANTON'S  PHYSIOGNOMY' —Reduced 


SYSTEMS   AND    FACULTIES    REQUIRED    EOE   A   SURGEOK.  1143 

is  a  dangerous  being) ;  he  should  develop  his  friendliness,  love  of 
cliildven,  and  of  tlie  opposite  sex;  in  short,  he  shoidd  be  a  Icmer 
of  It/amcmiiy, 

THE   SYSTEMS    AND    FACULTIES    REQUIRED   FOB   A   SURGEON. 

The  best  form,  for  a  snrgcon  who  attempts  the  most  severe 


No  scientific  physiocnunii^t  could  mistake  this  face  for  other  than  that  of  a  physi- 
cian, and  an  earnest  and  attentive  one  aa  well,  as  evidenced  by  the  signs  of  "natural 
Fhvsician"  in  the  cheek-bone^,  in  thenttitudeof  the  head  and  neck,  and  by  the  thought- 
ul,  observant  expression  of  the  eye.  Tlie  combination  of  systems  in  this  subject  is  such 
as  is  most  frequeiill>  observed  among  physicians,  viz..  the  supremacy  of  the  osseous  and 
brain  systems.  The  muscular,  thoracic,  and  vegetative  powers  all  assist  in  this  com- 
binatioii  by  their  development.  The  signs  for  (Conscience  and  Firmness  are  apparent. 
I^ve  of  Home  and  Patriotism  rank  hign.  Benevolence,  Amaliveness,  Love  oi  Young, 
Mirth,  Approbation,  Self-eslet*ni,  Modesty,  Friendship.  Alinientiveness,  Sanativenesa, 
Pneumativenefls.  and  Color  combine  to  form  a  lovely  domestic  and  social  nature.  The 
form,  size,  and  peculiaritie.-*  of  the  nose  claim  attention.  It  is  a  nose  denoting  Con- 
fltmctiveness.  Originality,  and  logical  power.  The  signs  for  Hope.  Analysis,  Mental 
Imitation,  Human  Nature.  Ideality,  Sublimity,  Construction,  and  Acquisition  are 
Htrongly  delineated.  Self-will  is  normallv  developed,  while  Size.  Form.  Observation, 
Weight.  Localitv,  Calculation,  and  Memory  of  various  sorts  are  manifest.  The  signs 
of  Language  in  theeveund  mouth  Ueuute  tiuencv,  while  the  practical  faculties,  bemg 
dominant,  would  give  clearness,  perspicacity,  ami  directness  to  his  styleof  expression, 
either  oral  or  written.  Time.  Oider.  Reason,  and  Intuition  are  well  developed.  The 
long-continued  observation  and  experiments  of  this  noble  physician  in  his  endeavor 
to  protect  huroanitv  from  the  ravages  of  small-pox  by  his  discovery  of  vaccination, 
met  at  last  with  a  suitable  recognition,  for  he  received  by  a  vote  of  Parliament  the 
sum  of  £30,000,  and  special  honors  wercawarded  him,  Tt  is  a  singular  fact  that  all  of 
t  he  beVef  actors  of  the  human  race— those  whg  havebenettted  it  by  discoveries  of  any 
kind  Tvhatever— have  met  with  the  most  vioIeiU  wpposition,  treachery,  and  often 
di-sgrace.  before  thev  could  make  the  world  see  the  value  of  their  discoveries.  Such 
was  the  case  with  Dr.  Jenner,  but  his  firmness  and  truth  at  last  gained  the  victory. 

operations  is  the  round  build  of  body  and  head,  and  many  of  them 
are  of  this  shape.  The  muscular  system  should  be  supreme,  with 
the  brain  system  a  close  second,  the  bony  and  thoracic  systems 
about  equal  and  next  in  development 

The  muscular  tissue  is  comparatively  unfeeling — msensitive; 


FACSIMILE  PAGE  FROM  "STANTON'S  PHYSIOGNOMY"— Reduced. 


OTHEE   CLASSES   OF   SUEGEONS.  1145 

in  the  body.  Form  and  Size  are  also  requisite  to  aid  the  memorj  of 
the  shape  and  relative  position  of  each  pait,  and  to  assist  Locality. 
Human  Nature  is  essential  in  order  that  he  may  be  en  rapport 
with  his  patients,  and  also  to  enable  him  to  diobie  instinctively  all 
bodily  and  mental  states.  He  should  be  a  good  physiognomist,  and 
be  well  versed  in  the  pathologi/  of  ])hysiognomy.  He  must  have 
large  Observation,  in  order  to  take  cognizance  of  the  most  minute 
changes  and  appearances.  Calculation  is  a  useful  trait  also,  as  it 
is  required  in  many  ways  in  the  medication  and  treatment  of  the 
wounded,  as  in  chemistry  and  in  making  suigical  implements,  etc. 
He  should  have  large  Friendship,  in  order  to  attach  his  patients  to 
him  and  to  command  their  esteem;  enough  Benevolence  to  sympa- 
thize, but  not  enough  to  weaken  the  feelings  when  severity  is 
required.  The  faculty  of  Amativeness  is  necessary  to  cornprehend 
the  nature  of  the  opposite  sex;  Love  of  Young  also,  that  he  may 
inspire  children  with  love  and  confidence. 

The  sense  of  Weight  should  be  a  strong  one,  for  the  muscular 
sense  is  dependent  upon  its  poucr  in  order  to  garige  the  amount 
of  force  to  be  used  in  handling  instruments  and  in  bandaging 
wounds,  limbs,  etc.  Exccutivene.ss  is  required  to  assist  authority 
and  give  resistance.  Self-will  is  another  ally  most  necessary,  as 
well  as  Analysis,  Time,  Order,  and  Reason.  A  fair  share  of 
musical  ability  is  required  to  assist  the  ear  in  making  examinations 
of  the  heart  and  lungs,  and  in  auscultation  for  various  other  pur- 
poses. If  to  these  laculties  one  adds  large  Intuition,  he  has  a  fine 
bodily  and  mental  equipment  for  the  jiractice  of  surgery. 

OTHER   CLASSES   OF   SURGEONS 

Many  army  surgeons  are  characterized  by  a  round  and  broad 
form,  with  broad,  rather  low,  and  round  heads;  short,  round  arms, 
and  round  and  tapering  fingers.  This  build  is  the  most  suitable 
for  those  severe  operations  which  require  the  greatest  exhibition  of 
force,  endurance,  and  coolness;  another  class  of  surgeons — those 
who  undertake  the  more  delicate  and  less  forceful  operations — are 
characterized  by  about  an  equal  de\elopment  of  the  brain  and 
muscular  systems.  This  class  of  surgeons  tend  naturally  to  the 
treatment  of  those  finer,  less  difficult,  and  more  delicate  cases  of 
operative  surgery,  such,  for  example,  as  treatment  of  the  ear,  the 
eye.  etc.  This  class  of  surgeons  require  a  fine  endowment  of  the 
brain  and  nervous  system.  In  short,  the  muscles  as  well  as  ner^•es 
of  this  class  must  be  sensitive  to  a  great  degree,  and  this  combi- 
nation calls  for  a  fine  and  high  organization. 

The  surgeon  should  be  something  of  an  actor  in  order  to 
tnow  when  to  be  sympathetic  and  when  to  be  severe.     Yet  he 


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Press.    Nearly  Ready. 

BOWEN— Hand- Book  of   Materia   Medica,   Pharmacy, 
and  Therapeutics. 

By  CuTHBERT  BowEK,  M.D.,  B.A.,  Editor  of  "Notes  on  Prac- 
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No.  2  in  the  Physiciaiis'  and  Students'  Ready-Refe^'enoe  Series. 

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The  F.  A.  Davis  Co.,  Philadelphia,  Pa.  3 

BURET — Syphilis   in   Ancient  and   Prehistoric    Times. 

With    a    Chapter   on    the    Bational    Treatment   of 
Syphilis  in  the  Nineteenth  Century. 

By  Dr.  F.  Buret,  Paris,  France.  Translated  from  the  French, 
with  the  author's  permission,  with  notes,  by  A.  H,  Ohmann-Dumesnil, 
Professor  of  Dermatology  and  Syphilology  in  the  St.  Louis  College  of 
Physicians  and  Surgeons.  Ho.  12  in  the  Physiciaiis'  and  Studetits' 
Ready-Reference  Se)-ies.     230  pages.     12mo.    Extra  Dark-Blue  Cloth. 

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This  volume,  which  is  one  of  a  series  of  three  (the  other  two,  treating  of 
Syphilis  in  the  Middle  Ages  and  in  Modern  Times,  now  in  active  prepara- 
tion), gives  the  most  complete  history  of  Syphilis  from  prehistoric 
times  up  to  the  Christian  Era.  The  subject  throughout  is  treated  in  a 
clear,  concise  manner,  and  readers  will  find  many  things  which  are 
historically  new. 

CAPP — The  Daughter.  Her  Health,  Education,  and 
Wedlock.  Homely  Suggestions  to  Mothers  and 
Daughters. 

By  William  M.  Capp,  M.D.,  Philadelphia.  This  is  just  such  a 
book  as  a  family  physician  would  advise  his  lady  patients  to  obtain 
and  read.  It  answers  many  questions  which  every  busy  practitioner 
of  medicine  has  put  to  him  in  the  sick-room  at  a  time  when  it  is 
neither  expedient  nor  wise  to  impart  the  information  sought.  12mo. 
150  pages.     Attractively  bound  in  Extra  Cloth. 

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CATHELL — Book  on  the  Physician  Himself,  and  Things 
that  Concern  His  Reputation  and  Success. 

By  D.  W.  Cathell,  M.D.,  Baltimore,  Md.  Tenth  Edition. 
Author's  last  revision,  enlarged  and  perfected.  Royal  Octavo,  about 
350  pages,  Extra  Cloth. 

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CLEVENGER — Spinal  Concussion.  Surgically  Consid- 
ered as  a  Cause  of  Spinal  Injury,  and  Neurologi- 
cally  Restricted  to  a  Certain  Symptom  Group,  for 
which  is  Suggested  the  Designation  "  Erichsen'^s 
Disease,''''  as  One  Form  of  the  Traumatic  Neuroses. 

By  S.  V.  Clevenger,  M.D.,  Consulting  Physician,  Reese  and 
Alexian  Hospitals  ;  Late  Pathologist,  County  Insane  Asylum,  Chicago; 
Member  of   numerous   American  Scientific  and  Medical    Societies ; 


4  The  F.  A.  Davis  Co.,  Philadelphia,  Pa. 

Collaborator,  Alienist  and  Neurologist,  Journal  of  Neurology  and 
Psychiatry,  Journal  of  Nervous  and  Mental  Diseases ;  Author  of 
"  Comparative  Physiology  and  Psychology,"  etc. 

This  book  is  the  outcome  of  five  years'  special  study  and  experience 
in  legal  circles,  clinics,  hospital  and  private  practice,  in  addition  to 
twenty  years'  labor  as  a  scientific  student,  writer,  and  teacher.  Evei-y 
Physician  and  Lawyer  should  ovm  this  work.  Koyal  Octavo,  nearly  400 
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COLTMAN — The  Chinese:  Their  Present  and  Future; 
Medical,  Political,  and  Social. 

By  Robert  Coltman,  Jr.,  M.D.,  Surgeon  in  Charge  of  the 
Presbyterian  Hospital  and  Dispensary  at  Teng  Chow  Fu  ;  Consulting 
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Beautifully  printed  in  large,  clear  type,  illustrated  with  Fifteen 
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DAVIS— Consumption :  How  to  Prevent  it  and  How  to 
Live  with  it.  Its  Nature,  Causes,  Prevention,  and 
the  Mode  of  Life,  Climate,  Exercise,  Food,  and 
Clothing  Necessary  for  its  Cure. 

By  N.  S.  Davis,  Jr.,  A.M.,  M.D.,  Professor  of  Principles  and 
Practice  of  Medicine,  Chicago  Medical  College ;  Physician  to  Mercy 
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DAVIS — Diseases  of  the  Lungs,  Heart,  and  Kidneys. 

By  N.  S,  Davis,  Jr.,  A.M.,  M.D.,  Professor  of  Principles  and 
Practice  of  Medicine,  Chicago  Medical  College ;  Physician  to  Mercy 
Hospital,  Chicago;  Member  of  the  American  Medical  Association, 
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DEMARQUAY — On  Oxygen.  A  Practical  Investigation 
of  the  Clinical  and  Therapeutic  Value  of  the 
Gases  in  Medical  and  Surgical  Practice,  with  Espe-. 


The  F.  A.  Davis  Co.,  Philadelphia^  Pa.  5 

cial    Reference    to     the     Value     and    Availability 

of    Oxygen^    Nitrogen,    Hydrogen,   and    Nitrogen 

Monoxide. 

By  J.  N.  Demakquat,  Surgeon  to  the  Municipal  Hospital,  Paris, 
and  of  the  Council  of  State  ;  Member  of  the  Imperial  Society  of  Sur- 
gery, etc.  Translated,  with  notes,  additions,  and  omissions,  by  Samuel 
S.  Wallian,  A.m.,  M.D.,  Ex-Presideut  of  the  Medical  Association 
of  Northern  New  York ;  Member  of  the  New  York  County  Medical 
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EDINGER — Twelve  Lectures  on  the  Structure  of  the 

Central    Nervous    System.      For    Physicians    and 

Students. 

By  Dr.  Ludwig  Edinger,  Frankfort-on-the-Main.  Second  Re- 
vised Edition.  With  133  illustrations.  Translated  by  Willis  Hall 
ViTTUM,  M.D.,  St.  Paul,  Minn.  Edited  by  C.  Eugene  Riggs,  A.M., 
M.D.,  Professor  of  Mental  and  Nervous  Diseases,  University  of  Minne- 
sota; Member  of  the  American  Neurological  Association.  The  illus- 
trations are  exactly  the  same  as  those  used  in  the  latest  German 
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very  satisfactory  to  the  Physician  and  Student  using  the  book.  Royal 
Octavo,  about  250  pages.  Extra  Cloth. 

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EISENBERG — Bacteriological  Diagnosis.    Tabular  Aids 

for  Use  in  Practical  Work. 

By  James  Eisejtberg,  Ph.D.,  M.D.,  Vienna.  Translated  and 
augmented,  with  the  permission  of  the  author,  from  the  second 
German  Edition,  by  Norval  H.  Pierce,  M.D.,  Surgeon  to  the  Out- 
Door  Department  of  Michael  Reese  Hospital ;  Assistant  to  Surgical 
Clinic,  College  of  Physicians  and  Surgeons,  Chicago,  111.  Nearly  200 
pages.  In  one  Royal  Octavo  volume,  handsomely  bound  in  Cloth  and 
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GOOD  ELL — Lessons  in  Gynaecology. 

By  William  Good  ell,  A.M.,  M.D.,  etc.,  Professor  of  Clinical 
GynsBcology  in  the  University  of  Pennsylvania.      With  112  illustra- 


6  The  F,  A.  Davis  Co.,.  Philadelphia,  Pa. 

tions.     Third  Edition,  thoroughly  revised  and  greatly  enlarged..    One 
volume,  large  Octavo,  578  pages. 

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GUERNSEY— Plain  Talks  on  Avoided  Subjects. 

By  Henry  N.  Guernsey,  M.D.,  formerly  Professor  of  Material 
Medica  and  Institutes  in  the  Hahnemann  Medical  College  of  Philadel- 
phia ;  Author  of  Guernsey's  "  Obstetrics,"  including  the  Disordera 
Peculiar  to  Women  and  Young  Children,  etc. 

Contents  of  the  Book. — I.  Introductory.  II.  The  Infant.  III.. 
Childhood.  IV.  Adolescence  of  the  Male.  V.  Adolescence  of  the 
Female.  VI.  Marriage  :  The  Husband.  VII.  The  Wife.  VIII.  Hus- 
band and  Wife.  IX.  To  the  Unfortunate.  X.  Origin  of  the  Sex, 
16mo,  bound  in  Extra  Cloth. 

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HARE — Epilepsy:  its  Pathology  and  Treatment.  Being 
an  Essay  to  which  was  Awarded  a  Prize  of  Four 
Thousand  Francs  by  the  Academie  Royal  de  Mede- 
cine  de  Belgique,  December  SI,  1889. 

By  HoBART  Amory  Hare,  M.D.,  B.Sc,  Professor  of  Materia 
Medica  and  Therapeutics  in  the  Jefferson  Medical  College,  Philadel- 
phia; Physician  to  St.  Agnes'  Hospital  and  to  the  Children's  Dispen- 
sary of  the  Children's  Hospital,  Philadelphia,  etc.  Laureate  of  the 
Eoyal  Academy  of  Medicine  in  Belgium,  of  the  Medical  Society  of 
London,  etc.  12mo.  228  pages.  Extra  Cloth.  No.  7  in  the  Physi- 
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HARE — Fever:  its  Pathology  and  Treatment.  Being 
the  Boylston  Prize  Essay  of  Harvard  University 
for  1890  ;  containing  Directions  and  the  Latest  In- 
formation Concerning  the  Use  of  the  So-Called 
Antipyretics  in  Fever  and  Pain. 

By  HoBART  Amory  Hare,  M.D.,  B.Sc.  Illustrated  with  more 
than  25  new  plates  of  tracings  of  various  fever  cases,  showing  beauti- 
fully and  accurately  the  action  of  the  antipyretics.  The  work  also 
contains  35  carefully-prepared  statistical  tables  of  249  cases,  showing 
the  untoward  effects  of  the  antipyretics.  12mo.  Extra  Cloth.  No. 
10  in  the  Physicians'  and  Students'  Ready-Reference  Series. 

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The  F.  A.  Davis  Co.,  Philadelphia,  Pa.  K 

HUIDEKOPER— Age  of  the  Domestic  Animals.      Being 

a  Complete  Treatise  on  the  Dentition  of  the  Horse^ 

Ox,  Sheep,  Hog,  and  Dog,  and  on  the  Various  Other 

Means  of  Determining  the  Age  of  tliese  Animals. 

By  Rush  Shippen  Huidekopee,  M.D.,  Veterinariaii  (Alfort, 
France)  ;  Professor  of  Sanitary  Medicine  and  Veterinary  Jurispru- 
■dence,  American  Veterinary  College,  New  York ;  Late  Dean  of  the 
Veterinary  Department,  University  of  Pennsylvania,  etc.  Royal 
Octavo,  225  pages.     Extra  Cloth.     200  Wood-Engravings. 

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Great  Britain,  10s. ;  France,  12  fr.  20. 

International  System  of  Electro-Therapeutics. 

Chief  editor,  Hokatio  R.  Bigelow,  M.D.,  Permanent  Member  of 
the  American  Medical  Association ;  Fellow  of  the  British  Gynaeco- 
logical Society;  Fellow  of  the  American  Electro-Therapeutic  Associa- 
tion ;  Member  of  the  Philadelphia  Obsteti-ical  Society ;  Member  of  the 
^ociete  Francaise  d'Electro-Th6rapie ;  Author  of  "  Gynaecological 
Electro-Therapeutics,"  and  "  Familiar  Talks  on  Electi-icity  and 
Batteries."  Assisted  by  upward  of  thirty  eminent  specialists  in 
Europe  and  America  as  associate  editors.  Thoroughly  illustrated  with 
many  fine  engravings.     Over  900  pages.     Royal  Octavo.    In  Peess. 

IVINS — Text- Book  on  Diseases  of  the  Nose  and  Throat. 

By  Horace  F.  Ivins,  M.D.,  Lecturer  on  Laryngology  and  Otology 
in  Hahnemann  Medical  College  and  Hospital,  Philadelphia ;  Laryngo- 
logical  Editor  of  the  "Journal  of  Ophthalmology,  Otology,  and 
Laryngology,"  etc.,  etc.  Royal  Octavo,  about  500  pages.  Beautifully 
printed,  with  very  many  colored  plates  and  other  engravings,  Chiefly 
Original,  from  drawings  and  photographs  of  Anatomical  Dissections, 
etc.    In  Pbess.    Ready  in  the  Fall  of  1892. 

KEATING — Record-Book  of  Medical   Examinations  for 
Life-Insurance. 

Designed  by  John  M.  Keating,  M.D.  This  record-book  is 
small,  but  complete,  and  embraces  all  the  principal  points  that  are 
required  by  the  different  companies.  It  is  made  in  two  sizes,  viz : 
No.  1,  covering  one  hundred  (100)  examinations,  and  No.  2,  covering 
two  hundred  (200)  examinations.  The  size  of  the  book  is  7  x  Z% 
inches,  and  can  be  conveniently  carried  in  the  pocket. 

Prices,  post-paid :  No.  1,  for  lOO  examinations.  United  States 
and  Canada,  Cloth,  50  cents,  net ;  Great  Britain,  3s.  6d. ; 
France,  3  fr.  60.  No.  2,  for  200  Fxaminations,  Full 
liCatlier,  frith  Side-Flap,  United  States  and  Canada^ 
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8  The  F.  A.  Davis  Co.,  Philadelphia,  Pa. 

KEATING  AND  EDWARDS— Diseases  of  the  Heart 
and  Circulation  in  Infancy  and  Adolescence.  With 
an  Appendix  entitled  ^'Clinical  Studies  on  the 
Pulse  in  Childhood. 

By  Jons'  M.  Keating,  M.D.,  formerly  Obstetrician  to  the  Phila- 
delphia Hospital  and  Lecturer  on  Diseases  of  Women  and  Children  ; 
Surgeon  to  the  Maternity  Hospital,  Philadelphia,  etc. ;  and  William 
A.  Edwards,  M.D.,  formerly  Instructor  in  Clinical  Medicine  and 
Physician  to  the  Medical  Dispensary  in  the  University  of  Pennsyl- 
vania, and  Assistant  Pathologist  to  the  Philadelphia  Hospital,  etc. 
Illustrated  by  Photographs  and  Wood-Engravings.  About  225  pages. 
8to.     Bound  in  Cloth. 

Price,  in  United  States  and  Canada,  post-paid,  $1.50,  net; 
Great  Britain,  8s.  6d. ;  France,  9  £r.  35. 

LIEBIG  AND  ROME— Practical  Electricity  in  Medicine 
and  Surgery. 

By  G.  A.  LiEBiG,  Jr.,  Ph.D..  Assistant  in  Electricity,  Johns  Hop- 
kins University;  Lectui-er  on  Medical  Electricity,  College  of  Physi- 
cians and  Surgeons,  Baltimore,  etc. ;  and  George  H.  Rohe,  M.D., 
Professor  of  Obstetrics  and  Hygiene,  College  of  Physicians  and  Sur- 
geons, Baltimore  ;  Visiting  Physician  to  Bay  View  and  City  Hospitals ; 
Director  of  the  Maryland  Maternity,  etc.  Profusely  Illustrated  by 
Wood-Engravings  and  Original  Diagrams.  Royal  Octavo,  383  pages, 
Extra  Cloth. 

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Great  Britain,  lis.  6d ;  France,  12  fr.  40. 

MANTON — Childbed;  its  Management;  Diseases  and 
their  Treatment. 

By  Walter  P.  Maxtox,  M.D.,  Visiting  Physician  to  the  Detroit 
Woman's  Hospital ;  Consulting  Gynaecologist  to  the  Eastern  Michigan 
Asylum ;  President  of  the  Detroit  Gynaecological  Society ;  Fellow  oT 
the  American  Society  of  Obstetricians  and  Gynascologists,  and  of  the 
British  G3'n£ecological  Society,  etc.  In  one  neat  12mo  volume.  In 
Prepakatiox. 

MASSEY — Electricity  in  the  Diseases  of  Women.  With 
Special  Reference  to  the  Application  of  Strong 
Curreyits. 

By  G.  Betton  Masset,  M.D.,  Physician  to  the  Gynaecological 
Department  of  the  Howard  Hospital ;  Late  Electro-Therapeutist  to  the 
Philadelphia  Orthopaedic  Hospital  and  Infirmary  for  Nervous  Diseases ; 
Member  of  the  American  Neurological  Association,  etc.  Second 
Edition.  Revised  and  enlarged.  With  New  and  Original  Wood- 
Engravines.  Handsomely  bound  in  Dark-Blue  Cloth.  2iO  pages. 
12mo.     No.  5  in  the  Physicians'  and  Students'  Ready-Refer e'lice  Sei'ies. 

Price,  in  United  States  and  Canada,  post-paid,  $1.50,  net; 
Creat  Britain,  8s.  6d. ;  France,  9  fr.  35. 


The  F.  A.  Davis  Co.,  Philadelphia,  Pa.  9 

Medical  Bulletin  Visiting  List,  or  Physicians'  Call  Record, 

Arranged  upon  an  Original  and  Convenient  Monthly 
and  Weekly  Plan  for  the  Daily  Recording  of  Pro- 
fessional Visits. 

This  is,  beyond  question,  the  best  and  most  convenient  time-  and 
labor-  saving  physicians'  pocket  record-book  ever  published.  Physi- 
cians of  many  years'  standing  and  with  large  practices  pronounce 
this  the  best  list  they  have  ever  seen.  It  is  handsomely  bound  in  fine 
strong  leather,  with  flap,  including  a  pocket  for  loose  memoranda,  etc., 
and  is  furnished  with  a  Dixon  lead-pencil  of  excellent  quality  and 
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£r.  20. 

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MICHENER — Hand>6ook  of  Eclampsia ;   or,  Notes  and 
Cases  of  Puerperal  Convulsions. 

By  E.  MiCHENER,  M.D. ;  J.  H.  Stubbs,  M.D.  ;  R.  B.  Ewing, 
M.D. ;  B.  Thompsox,  M.D. ;  S.  Stebbixs,  M.D.     16mo.     Cloth. 

Price,  60  cents,  net ;  Great  Britain,  4s.  6d. ;  France,  4  fr.  20. 

MONTGOMERY— Practica!  Gynaecology. 

By  E.  E.  Montgomery,  A.M,,  M.D.,  Professor  of  Clinical  Gynae- 
cology in  the  JeflFerson  Medical  College,  Philadelphia;  Obstetrician  to 
the  Philadelphia  Hospital;  Gynaecologist  to  the  St.  Joseph  Hospital : 
Fellow  and  ex-President  of  the  American  Association  of  Obstetricians 
and  Gynaecologists,  etc.,  etc.  In  one  handsome  Royal  Octavo  volume. 
Thoroughly  and  beautifully  illustrated.    In  Preparation. 

NISSEN — A  Manual  of  Instruction  for  Giving  Swedish 
Movement  and  Massage  Treatment. 

By  Prof.  Haetvig  Nissen,  late  Director  of  the  Swedish  Health 
Institute,  Washington,  D.  C.  ;  late  Instructor  in  Physical  Culture  and 
Gymnastics  at  the  Johns  Hopkins  University,  Baltimore,  Md.  ;  In- 
structor of  Swedish  and  German  Gymnastics  at  Harvard  University's 
Summer  School,  1891,  etc.,  etc.  Illustrated  with  29  Original  Wood- 
Engravings.  In  one  12mo  volume  of  128  pages.  Neatly  bound  in 
Cloth. 

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10  The  F.  A.  Davis  Co.,  Philadelphia,  Pa. 

NISSEN— A  B  C  of  the  Swedish  System  of  Educational 
Gymnastics.  A  Practical  Eand-Book  for  School- 
Teachers  and  the  Home. 

By  Habtvig  Nissen.  The  author  has  avoided  the  use  of  diflQcult 
scientific  terms,  and  made  it  as  popular  and  plain  as  possible.  The 
fullest  instructions  and  commands  are  given  for  each  exercise,  and 
Sevmty-sei'eii  Excellent  Engravings  illustrate  them  and  add  greatly  to 
the  practical  value  of  the  book.  Small  12mo,  about  125  pages. 
Extra  Flexible  Cloth.     May  be  conveniently  carried  in  the  pocket. 

Price,  in  United  States  and  Canada,  post-paid,  75  cents,  net ; 
Great  Britain,  4s. ;  France,  4  fr. 

PACKARD— A  Practice  of  Surgery. 

By  John  H.  Packard,  A.M.,  M.D.,  Surgeon  to  the  Pennsylvania 
Hospital  and  to  St.  Joseph's  Hospital,  Philadelphia;  Member  of  the 
American  Surgical  Association  and  of  the  American  Medical  Associa- 
tion ;  formerly  Acting  Assistant  Surgeon  U.  S.  Army  (1861-65),  etc., 
etc.  In  one  large  Royal  Octavo  volume.  Handsomely  Hlustrated. 
In  Preparation. 

Physicians'  AU-Requisite  Time-  and  Labor-  Saving 
Account-Book.  Being  a  Ledger  and  Account-Book 
for  Physicians''  Use,  Meeting  all  the  Bequirements 
of  the  Law  and  Courts. 

Designed  by  "William  A.  Seibert,  M.D.,  of  Easton,  Pa.  There 
Is  no  exaggeration  in  stating  that  this  Account-Book  and  Ledger  re- 
duces the  labor  of  keeping  your  accounts  more  than  one-half,  and  at 
the  same  time  secures  the  greatest  degree  of  accuracy. 

To  all  physicians  desiring  a  quick,  accurate,  and  comprehensive 
method  of  keeping  their  accounts,  we  can  safely  say  that  no  book  as 
suitable  as  this  one  has  ever  been  devised. 

Prices,  Shipping  Expenses  Prepaid :  No.  1,  300  Pages,  for 
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A  circular  showing  the  plan  of  the  book  will  be  sent  free  to  any 
address  on  application. 

Physicians'  Interpreter:    In  Four  Languages  (English, 
French,  German,  and  Italian). 

Specially  arranged  for  diagnosis  by  M.  von  V,  The  object  of  this 
little  work  is  to  meet  a  need  often  keenly  felt  by  the  busy  physician, 
namely,  the  need  of  some  quick  and  reliable  method  of  communicating 


The  F.  A.  Davis  Co.,  Philadelphia^  Pa.  11 

intelligibly  with  patients  of  those  nationalities  and  languages  un- 
familiar to  the  practitioner.  The  plan  of  the  book  is  a  systematic 
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of  the  patient  is  merely  Yes  or  No.  The  questions  are  all  numbered, 
and  a  complete  Index  renders  them  always  available  for  quick  refer- 
ence. The  book  is  written  by  one  who  is  well-versed  in  English, 
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guages, and  who  has  also  had  considerable  hospital  experience.  Bound 
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206  pages. 

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PRICE  AND  EAGLETON— Three  Charts  of  the  Nervo- 

Vascular  System.     Part  I. —  The  Nerves.     Part  II. 

—  The  Arteries.     Part  III. —  The  Veins. 

A  New  edition,  Revised  and  Perfected.  Arranged  by  W.  Henry 
Price,  M.D.,  and  S.  Potts  Eagleton,  M.D.  Endorsed  by  leading 
Anatomists.  "The  Nervo- Vascular  System  of  Charts"  far  excels 
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Clearly  and  beautifully  printed  upon  extra-durable  paper.  Each  chart 
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PURDY — Diabetes:   its  Cause,  Symptoms,  and  Treat- 
ment. 

By  Chas.  W.  Purdy,  M.D.  (Queen's  University),  Honorary 
Fellow  of  the  Royal  College  of  Physicians  and  Surgeons  of  Kingston  ; 
Member  of  the  College  of  Physicians  and  Surgeons  of  Ontario  ;  Author 
of  "  Bright's  Disease  and  Allied  Affections  of  the  Kidneys ;  "  Member 
of  the  Association  of  American  Physicians  ;  Member  of  the  American 
Medical  Association  ;  Member  of  the  Chicago  Academy  of  Sciences, 
etc.,  etc.  With  Clinical  Illustrations.  In  one  neat  12mo  volume. 
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PURDY — A  Systematic  Treatise    on    Diseases  of  the 
Urinary  and  Renal  System. 

By  Chas.  W.  Purdy,  M.D.  (Queen's  University),  Author  of 
"  Bright's  Diseases  and  Allied  Affections  of  the  Kidneys  ;"  "  Diabetes  : 
its  Causes,  Symptoms,  and  Treatment,"  etc.  In  four  handy  12mo 
volumes.    Bound  in  Extra  Cloth,  handsomely  illustrated  with  colored 


12  Tae  F.  A.  Dams  Co.,  Philcdelphia,  Pa. 

plates  and  other  eDgrarings.  Volume  I. — The  Urine :  -formal  and 
Abnormal,  Chemically  and  ClinicaUy  considered.  Volume  II. — Dis- 
eases of  the  Urinary  Passages.  YdLnmes  III  and  IV. — Diseases  of 
the  Kidneys. 

Volnme  I  will  be  ready  early  in  1833.  Bemaining  Tolomes  will 
foUow  at  intervals  of  a  few  months  each. 

REMONDINO — History    of    Circumcision.      From    the 

Eirliis:  Tvn-s  to  :^?  Pre?e:i:.  Moral  and  Phys- 
io 2'.  Loz>y^'>  fo-'-  :->  ror/:''rr.:\\:i  ;  ici^h  a  History 
of  E:oo.o.oKii'o'..  Iiir-:r.o.y\rooiisr!\.  e:o..  and  of  the 
Different  Operations  Practiced  upon  the  Prepuce. 

Et  p.  C.  F.siioxDrs-0.  M.D.  ("Jefferson).  Member  of  the  American 
jIt  ".::/-  A;5  ;:ition:  of  The  American  Public  Health  Association: 
T:;t-7:  i:I::::  ::  Caliicmis,  S:a:e  Mrdieal  Society  and  of  Southern 
Ci.r—-^  ^^i;;a.  ^lirtr  -:  ::-:,  3i6  pages.  Extra  Clotb. 
r--u;:r;:ri  "~  i:':i  :~:  rir  :  .  .-TiCr  ~  .  1-  ngraTings,  showmg  flie  two 
r  :i.  -ji.  :_  ,t;  ::  C:r-  :  -=  :.  in  ancient  times.  So.  11  in  the 
P^;.  ;:.■;■■;; '    ■    .:  .^'^i.:■::;'  s.-.     '  -J::-:-:"iee  Serieg. 

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REMONDINO — The  Mediterranean  Shores  of  America. 

.S::-^-  ■;    ';'"■;-;    ^'?    Climatic.  Physical,   and 

Et  P,  C,  Pz:':::rr';::: .  M.D,,  ■._'^rrrri:'  ,  r"-:.  Complete  in  one 
haii'i£:~T>  -r::.:ri  'j;::t:  t;1ui_c  ::'  -rir.^  IT"  7 ares,  with  45  ap- 
rrrrriiir  ;".'.ui:r:.:::zi  ii^l  i  nnelj  exe:u:fi  ziai.^  ::  :L-r  r-gian.  show- 

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Britain,  45. ;   Prance,  5  fr. 

ROHE — Text- Book    of    Hygiene.       J.     Comprehensive 

I-oz-i-yi    ■:■:    :'- 0   F--v\:\vlii    c^i  pr-^--'.-,-  .-jf  Pre- 

Bt  Gz--:-z  E,  R-zz.  >:  P,,  Pr-:T;,>:r  ::  C'': ;:-:-;£  ar.  1  Hv^iene 
in  tti   C::;e-T    ::   ?i-r5:::-=   a:::   Sair^r  -£.   Palil-rr-:   Vrai:rr  of 


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The  F.  A.  Davis  Co.,  Philadelphia,  Fa.  13 

ROME — A  Practical  Manual  of  Diseases  of  the  Skin. 

By  Geobge  H.  Rohe,  M.D.,  assisted  by  J.  Williams  Loed, 
A.B.,  M.D.,  Lecturer  on  Dermatology  and  Bandaging  in  the  College 
of  Physicians  and  Surgeons ;  Assistant  Physician  to  the  Skin  De- 
partment in  the  Dispensary  of  Johns  Hopkins  Hospital.  12mo,  over 
300  pages,  bound  in  Extra  Dark-Blue  Cloth.  JTo.  IS  in  the  Phy- 
sicians' and  Students'  Ready-Iieference  Series. 

Price,  in  United  States  and  Canada,  post-paid,  $1.35,  net; 
Great  Britain,  6s.  6d. ;  France,  7  fr.  75. 

The  PRACTICAL  character  of  this  work  makes  it  specially  desirable 
for  the  use  of  students  and  general  practitioners.  The  nearly  one 
hundred  (100)  reliable  and  carefully  prepared  Formulae  at  the  end  of 
the  volume  add  not  a  little  to  its  practical  value. 


SAJOUS — Hay  Fever  and  its  Successful  Treatment  by 
Superficial  Organic  Alteration  of  the  Nasal  IVIucous 
Membrane. 

By  Chables  E.  Sajous,  M.D.,  formerly  Lecturer  on  Rhinology 
and  Laryngology  in  Jefferson  Medical  College  ;  Tice-President  of  the 
American  Laryngological  Association ;  Officer  of  the  Academy  of 
France  and  of  Public  Instruction  of  Venezuela  ;  Corresponding  Mem- 
ber of  the  Royal  Society  of  Belgium,  of  the  Medical  Society  of  Warsaw 
(Poland),  and  of  the  Society  of  Hygiene  of  France ;  Member  of  the 
American  Philosophical  Society,  etc.,  etc.  With  13  Engravings  on 
Wood.     12mo.     Bound  in  Cloth.     Beveled  edges. 

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SANNE — Diphtheria,  Croup:  Tracheotomy  and  Intuba- 
tion. 

From  the  French  of  A.  Sanite.  Translated  and  enlarged  by 
Henbt  Z.  Gill,  M.D.,  LL.D.  Diphtheria  having  become  such  a 
prevalent,  wide-spread,  and  fatal  disease,  no  general  practitioner  can 
afford  to  be  without  this  work.  It  will  aid  in  preventive  measures, 
stimulate  promptness  in  the  application  of  and  efficiency  in  treatment, 
and  moderate  the  extravagant  views  which  have  been  entertained 
regarding  certain  specifics  in  the  disease  diphtheria. 

A  full  Index  accompanies  the  enlarged  volume,  also  a  list  of 
authors,  making,  altogether,  a  very  handsome  Illustkated  Royal 
Octavo  volume  of  over  680  pages. 

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14  The  F.  A.  Davis  Co.,  Philadelphia,  Pa. 

SENN — Principles  of  Surgery. 

By  N.  Senn,  M.D.,  Ph.D.,  Professor  of  Principles  of  Surgery  and 
Surgical  Pathology  in  Rush  Medical  College,  Chicago,  111. ;  Professor 
of  Surgery  in  the  Chicago  Polyclinic  ;  Attending  Surgeon  to  the  Mil- 
waukee Hospital ;  Consulting  Surgeon  to  the  Milwaukee  County  Hos- 
pital and  to  the  Milwaukee  County  Insane  Asylum.  Royal  Octavo, 
with  109  fine  Wood-Engravings,  624  pages. 

Price,  in  United  States,  Cloth,  S4.50  ;  Sheep  or  Half-Russia, 
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SENN — Tuberculosis  of  the  Bones  and  Joints. 

By  N.  Senn,  M.D.,  Ph.D.,  author  of  a  text-book  on  the  "Prin- 
ciples of  Surgery,"  etc.,  etc.  In  one  handsome  Royal  Octavo  volume. 
Over  500  pages.  Illustrated  with  upwards  of  one  hundred  (100) 
engravings,  many  of  them  colored. 

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fr.  30. 

SHOEMAKER— Heredity,  Health,  and  Personal  Beauty. 

Including  the  Selection  of  the  Best  Cosmetics  for 
the  Skin,  Hair,  Nails,  and  All  Parts  Relating  to  the 
Body. 

By  John  V.  Shoemakeb,  A.M.,  M.D.,  Professor  of  Materia 
Medica,  Pharmacology,  Therapeutics,  and  Clinical  Medicine,  and 
Clinical  Professor  of  Diseases  of  the  Skin  in  the  Medico-Chirurgical 
College  of  Philadelphia ;  Physician  to  the  Medico-Chirurgical  Hos- 
pital, etc.,  etc.  This  is  jitst  the  book  to  place  on  the  waiting-room  table 
of  every  physician,  and  a  work  that  will  prove  iisefid  in  the  hands  of  your 
patients. 

It  is  largely  suggestive,  and  gives  wise  and  timely  advice  as  to 
when  a  physician  should  be  consulted.  Royal  Octavo,  435  pages, 
Extra  Cloth,  Beveled  Edges,  with  side  and  back  gilt  stamps,  and  Half- 
Morocco  Gilt  Top. 

Price,  in  United  States,  post-paid,  Cloth,  $3.50,  net;  Half- 
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Morocco,  33  fr. 

SHOEMAKER — Materia  Medica  and  Therapeutics.    With 
Especial  Reference  to  the  Clinical  Application  of 
Drugs. 
Being  the  second  and  last  volume  of  a  treatise  on  Materia  Medica, 

Pharmacology,  and  Therapeutics,  and  an  independent  volume  upon 

drugs. 


The  F.  A.  Davis  Co.,  Philadelphia,  Pa.  15 

By  John  V.  Shoemaker,  A.M.,  M.D.,  Professor  of  Materia 
Medica,  Pharmacology,  Therapeutics,  and  Clinical  Medicine,  and 
Clinical  Professor  of  Diseases  of  the  Skin  in  the  Medico-Chirurgical 
College  of  Philadelphia ;  Physician  to  the  Medico-Chirurgical  Hos- 
pital, etc.,  etc. 

This  volume  is  wholly  taken  up  with  the  consideration  of  drugs, 
each  remedy  being  studied  from  three  points  of  view,  viz.  :  the  Prep- 
arations, or  Materia  Medica ;  the  Physiology  and  Toxicology,  or  Phar- 
macology ;  and,  lastly,  its  Therapy.  It  is  thoroughly  abreast  of  the 
progress  of  Therapeutic  Science,  and  is  really  an  indispensable  book  to 
every  student  and  practitioner  of  medicine.  Royal  Octavo,  about  675 
pages.     Thoroughly  and  carefully  indexed. 

Price,  in  United  States,  post-paid,  Clotli,  S3.50 ;  Sheep,  S4.50, 
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net.  Great  Britain,  Cloth,  19s. ;  Sheep,  35s.  France, 
Cloth,  33  fr.  40 ;  Sheep,  38  fr.  60. 

The  first  volume  of  this  work  is  devoted  to  Pharmacy,  General 
Pharmacology,  and  Therapeutics,  and  remedial  agents  not  properly 
classed  with  drugs.  Royal  Octavo,  353  pages.  Price  of  volume  I, 
post-paid,  in  United  States,  Cloth,  $2.50,  net;  Sheep,  $3.25,  net, 
Canada,  duty  paid,  Cloth,  $2.75,  net ;  Sheep,  $8.60,  net.  Great  Britain, 
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Tlie  volumes  are  sold  separately. 


SHOEMAKER— Ointments    and   Oleates,  Especially  in 
Diseases  of  the  Skin. 

By  John  V.  Shoemakek,  A.M.,  M.D.  Second  Edition,  revised 
and  enlarged.  298  pages.  12mo.  Neatly  bound  in  Dark-Blue  Cloth. 
N'o.  6  in  tJm  Physicians'  and  Students'  Ready- Meference  Series. 

Price,  in  United  States  and  Canada,  post-paid,  S1.50,  net; 
Great  Britain,  8s.  6d. ;  Prance,  9  fr.  35. 

The  author  concisely  concludes  his  preface  as  follows:  "The 
reader  may  thus  obtain  a  conspectus  of  the  whole  subject  of  inunction 
as  it  exists  to-day  in  the  civilized  world.  In  all  cases  the  mode  of 
preparation  is  given,  and  the  therapeutical  application  described 
seriatim,  in  so  far  as  may  be  done  without  needless  repetition." 


SMITH — The  Physiology  of  the  Domestic  Animals.     A 

Text-Book  for   Veterinary   and  Medical   Students 

and  Practitioners. 

By  Robert  Meade  Smith,  A.M.,  M.D.,  Professor  of  Comparative 
Physiology  in  University  of  Pennsylvania  ;  Fellow  of  the  College  of 
Physicians  and  Academy  of  the  Natural  Sciences,  Philadelphia  ;  of  the 
American  Physiological  Society  ;  of  the  American  Society  of  Natural- 


16  The  F.  A.  Davis  Co.,  Philadelphia,  Pa. 

ists  ;  Associ6  Etranger  de  la  Soci6t6  Francaise  d'Hygi^ne,  ete.  Royal 
Octavo,  over  950  pages.  Profusely  illustrated  with  more  than  400  fine 
Wood-Engravings,  some  of  them  Colored. 

Price,  in  United  States,  Cloth,  $5.00;  Sheep,  S6.00,  net. 
Canada  (duty  paid).  Cloth,  S5.50 ;  Sheep,  $6.60,  net. 
Great  Britain,  Cloth,  88s;  Sheep,  32s.  France,  Cloth, 
30  fr.  30  ;  Sheep,  36  fr.  30. 

This  new  and  important  work  is  the  most  thoroughly  complete  in 
the  English  language  on  the  subject.  Without  being  overburdened 
with  details,  it  forms  a  complete  text-book  of  physiology,  adapted  to 
the  use  of  students  and  practitioners  of  both  veterinary  and  human 
medicine.  It  has  already  been  adopted  as  the  Text-Book  on  Physi- 
ology in  the  Veterinary  Colleges  of  the  United  States,  Great  Britain, 
and  Canada. 

SOZINSKEY — Medical  Symbolism.     Historical  Studies 
in  the  Arts  of  Healing  and  Hygiene. 

By  Thomas  S.  Sozinsket,  M.D.,  Ph.D.,  Author  of  "The 
Culture  of  Beauty,"  "The  Care  and  Culture  of  Children,"  etc. 
12mo.  Nearly  200  pages.  Neatly  bound  in  Dark-Blue  Cloth.  Appro- 
priately illustrated  with  upward  of  thirty  (30)  new  Wood-Engravings. 
N'o.  9  in  the  Physicians'  and  Students'  Ready-Beferemx  Series. 

Price,  in  United  States  and  Canada,  post-paid,  $1.00,  net; 
Great  Britain,  6s. ;  France,  6  fr.  30. 

STEWART — Obstetric  Synopsis.   A  Complete  Gompend. 

By  John  S.  Stewaht,  M.D.,  Demonstrator  of  Obstetrics  and 
Chief  Assistant  in  the  Gynaecological  Clinic  of  the  Medico-Chirurgical 
College  of  Philadelphia ;  with  an  introductory  note  by  William  S, 
Stewaet,  A.m.,  M.D.,  Professor  of  Obstetrics  and  Gynaecology  in  the 
Medico-Chirurgical  College  of  Philadelphia.  43  Illustrations.  202 
pages.  12mo.  Handsomely  bound  in  Dark-Blue  Cloth.  Ho.  1  in  the 
Physicians'  and  Students'  Beady-Refereme  Series. 

Price,  in  United  States  and  Canada,  post-paid,  $1.00,  net ; 
Great  Britain,  6s.  France,  6  fr.  30. 

ULTZMANN— The  Neuroses  of  the  Genito- Urinary  Sys- 
tem in  the  Male.      With  Sterility  and  Impotence. 

By  Dr.  Ultzmann,  Professor  of  Genito-Urinary  Diseases  in 
the  University  of  Vienna.  Translated,  with  the  author's  permission, 
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Psychopathia    Sexualis.       With  Especial  Reference  to 

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